Objective: The Covid-19 pandemic has raised significant concerns about public health, particularly in terms of mental well-being due to heightened fear and uncertainty. The findings of this study are based on a survey conducted to evaluate the mental health status of the general population in Croatia during the Covid-19 pandemic. Methods: A survey conducted randomly and cross-sectionally included 588 respondents from all 21 counties in Croatia. The survey gathered demographic data and assessed various factors related to pandemic response measures and mental health using the Mental Health Continuum-Short Form (MHC-SF) scale. Results: Despite feeling adequately informed about Covid-19 (76.0%), most respondents (60.8%) expressed concerns about their loved ones during the pandemic. There were significant numbers who felt there was no risk of infection (50.9%) or believed they would not get infected (40.2%), while 72.4% were content with government measures. Statistical analysis indicated that mental health was not significantly different between genders, but age-related differences were evident, with those under 21 experiencing the most distress. The lowest level of psychological and social well-being was observed in respondents who were unemployed. Conclusions: The study identifies vulnerable groups in the Croatian population during the pandemic, including younger individuals, those on parental leave, students, and the unemployed, who exhibited worse mental health. The importance of implementing targeted mental health interventions to support these vulnerable groups is highlighted by these findings.

Consumers often cite cognitive improvements as reasons for making dietary changes or using dietary supplements, a motivation that if leveraged could greatly enhance public health. However, rarely is it considered whether standardized cognitive tests that are used in nutrition research are aligned to outcomes of interest to the consumer. This knowledge gap presents a challenge to the scientific substantiation of nutrition-based cognitive health benefits. Here we combined qualitative consumer research and expert group methodology to (1) understand how consumers comprehend the potential benefits of nutrition for brain health, and (2) determine the alignment between consumers' articulated brain benefits and validated tests and tools. We derived a ‘Consumer Taxonomy of Cognitive and Affective Health in Nutrition Research’ which describes the cognitive and affective structure from the consumers' perspective. Experts agreed that validated tests exist for some consumer benefits including focused attention, sustained attention, episodic memory, energy levels, and anxiety. Prospective memory, flow, and presence represented novel benefits that require the development and validation of new tests and tools. Closing the gap between science and consumers, and fostering co-creative approaches to nutrition research, are critical to the development of products and dietary recommendations that support realizable cognitive benefits that benefit public health.

Background: Delivery of quality family planning services depends on availability of skilled health care providers, which is often a challenge in Low- and middle-income countries. This study evaluates the effects of a targeted training program on family planning services delivered by the Lady Health Workers (LHWs) in six districts of Punjab, Pakistan. The primary goal was to enhance the quality and accessibility of family planning services, recognizing the pivotal role of LHWs in community health. Methods: Using a robust panel data difference-in-differences (DiD) approach, we analyzed the electronic medical records (EMR) of 1,410 LHWs over a nine-month period. This timeframe in-cluded both pre-training (July to December 2022) and post-training (April to June 2023) phases. Our assessment focused on the impact of training on five outcome variables: the number of follow-up clients, the number of Intrauterine Contraceptive Device (IUCD) clients, the number of condom clients, the number of modern method clients, and the number of injection clients. We also con-sidered control variables such as LHW age, LHW education, the number of eligible couples in each LHW's catchment area, and a categorical variable for the districts. Results: The positive and statistically significant (p<0.05) coefficients across various service cat-egories – Follow Up Clients [Coeff: 1.00, CI: (0.30 - 1.70)], IUCD Clients [Coeff: 0.23, CI: (-0.01 - 0.46)], Condom Clients [Coeff: 1.41, CI: (0.97 – 1.86)], Modern Method Clients [Coeff: 1.82, CI: (0.96 – 2.68)], and Injection Clients [Coeff: 0.32, CI: (0.14 – 0.50)]. These findings indicate enhanced productivity among LHWs who have received training, with results significant at the 95% con-fidence interval (CI). Conclusion: The study highlights the effectiveness of targeted training programs in boosting family planning services at the community level and offers insightful implications for policy-makers and health practitioners. While focused on six districts in Punjab, these promising results emphasize the need for ongoing training and support for frontline health workers to bolster family planning initiatives.

This study aimed to expand and inform the growing body of research on Postpartum Depression, from a netnographic standpoint, for the social media platform of Pinterest. More specifically, it aimed to assess the type of content present on Pinterest regarding Postpartum Depression shared by women in 2018 and 2021, as well as examine the subjective experience of women who have experienced this mood disorder. Data were collected following a search using the keywords “Postpartum Depression” on Pinterest on two separate timestamps (2018 and 2021); pins were limited to those in English or French. Master themes were identified among all pins and those identified as “self-disclosure” were subsequently further analyzed. Self-disclosure data were separately analysed using thematic analysis, specifically adopting a deductive thematic approach for the 2021 data set stemming from the coding scheme created from analysis of the 2018 data. Major themes were identified, and an analysis of frequency was performed for each sub-theme, along with qualitative examples associated with each theme. A total of 483 Pinterest pins from two different time points of 2018 (169 pins) and 2021 (314 sample pins) were analyzed. Five primary categories were identified in both 2018 and 2021, with five additional categories being identified in the 2021 dataset. Comparative results from 2018 and 2021 self-disclosure pins show individuals’ varying yet similar subjective manifestations of PPD, the potential need to adopt a multidisciplinary treatment approach, and the societal fears, such as mental health stigma, that are playing a part in help-seeking behavior hesitancies. Our findings provide imperative insight into individuals’ subjective experiences with PPD; experiences that involve a sensitive and vulnerable topic. Netnographic research, along with Pinterest, must be taken into consideration for future work delving into women’s health issues, including those surrounding perinatal mental health.

Background: Patients’ effective hand hygiene helps to reduce healthcare-associated infections, prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. This study aimed to describe effective hand hygiene decisions based on the Health Action Process Ap-proach (HAPA) and whether this pattern is invariant for mental health. Methods: Data were collected cross-sectionally from patients who had previously been admitted to a hospital (N=279; study 1) and longitudinally from psychosomatic rehabilitation patients (N=1,073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding com-pliance, as well as social-cognitive variables of the HAPA, and mental health status were examined. Results: The trimmed HAPA framework fitted the data well (χ2=27.1, df=12, p<.01, CMIN/df=2.26, CFI=.97, RMSEA=.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior were found to be invariant with regard to mental health. Conclusion: The trimmed HAPA framework revealed to be a generic framework in explaining so-cial-cognitive processes relating to hand hygiene decisions. Helping individuals to perform hand hygiene recommendation requires intention formation and bridging the intention-behavior gap. This can be done by promoting planning and self-efficacy. All processes appear generic to partic-ipants with and without mental health challenges.

Dairy calves are susceptible to a great range of welfare and health issues up to the age of weaning. The aim of the current pilot study was to evaluate incidence of the main health disorders affecting dairy calves up to one year of age. The study was carried out at the Experimental Farm of the Research and Development Institute for Bovine Balotesti, Romania, were health data was collected for two consecutive years, between November 2017 and October 2019, from a number of 176 purebred Romanian Black and White calves. Diarrhea had the highest incidence in un-weaned calves (0-3months old), of 29.55±0.34%, significantly higher (p≤0.001) compared to 3-6 months (2.16±1.24) and 6-12 months age groups (5.88±2.17), respectively. Coccidiosis incidence was on average of 39.20±0.36% in un-weaned calves, 1.44±1.01% in the 3-6 months group and of 5.04±2.01% in the 6-12 months group, significantly higher (p≤0.001) in the 0-3 months age group, compared to older calves.

The persistent burden of chronic hepatitis B among ≤5-year-old children in Africa suggests missed opportunities for controlling mother-to-child transmission (MTCT) of the hepatitis B virus (HBV). This scoping review maps the evidence base on the risk of HBV MTCT, the status of HBV MTCT mitigation strategies including hepatitis B birth-dose vaccination, and the role of systems complexity on the suboptimal adoption and performance of hepatitis B birth-dose vaccination programs in Africa. Overall, 88 peer-reviewed and grey literature sources published between 2000–2022 were included in this review. The evidence base consistently argues for a growing risk of HBV MTCT amidst the HIV co-epidemic in the region. Without universal HBV screening programs integrated within broader antenatal care services, current selective hepatitis B birth-dose vaccination is unlikely to effectively interrupt HBV MTCT. We underscore critical health systems-related barriers to universal adoption and optimal performance of hepatitis B birth-dose vaccination programs in the region. To better conceptualize the role of complexity and system-wide effects on the observed performance of the program, we propose an adapted systems-based logic model. Ultimately, exploring contextualized complex systems approaches to scaling-up universal hepatitis B birth-dose vaccination programs should form an integral part of the regional research agenda.

The COVID-19 virus is spread to the respiratory system by minute airborne particles in contrast to large particle fomite transmission. Yet, an often-repeated health directive during the COVID-19 pandemic was to improve handwashing to limit the spread of the virus. Persistent handwashing can aggravate obsessive-compulsive disorder (OCD), diminishing mental health. Given that handwashing is unlikely to control the spread of COVID-19, it is pertinent to determine if the directive for handwashing to eradicate the COVID-19 virus increased the incidence of OCD and, as such, promoted negative mental health. This scoping review of the parameter, “handwashing, mental health, COVID-19, OCD”, conducted during July 2023, searched six relevant databases. The result was that negative mental health related to increased handwashing was evident both for those already diagnosed with OCD and regarding new cases of OCD throughout the duration of the pandemic. The conclusion is that health officials should update details of their health directives as information becomes available during a pandemic and, concerning COVID-19, the directive to concentrate on handwashing should have been relaxed once it was known that spread of the virus by fomite transmission was improbable. This likely would have reduced the incidence of OCD and improved mental health.

In order to cope with the challenges of physical and psychological aging in the indigenous people in Taiwan, most of the tribes in Taiwan set up cultural health stations for indigenous elderly. These community care facilities have practiced many health promotion activities, such as the reminiscence, life review, and arts activity. However, there was little exploration into the benefit of indigenous people’s practice the life review activity in Taiwan—the gap this study aimed to fill. This study adopts life review therapy through a set of innovative life review activity designs in indigenous older adults, including activity planning, and indigenous cultural elements. A qualitative study design using semi-structured interviews was used to obtain data from a purposive sample. Ten participants who assessed to the cultural health stations services and participated in the life review activities of the indigenous older adults in southern Taiwan were interviewed individually. The data were analyzed using Graneheim and Lundman’s qualitative content analysis. The theme—“experiences and benefits of participating”—and two categories with six subcategories emerged. The results demonstrated that the participation of the indigenous elderly in life review activities with cultural elements had obvious benefits for their mental health. Life review therapy can be incorporated as a supplementary LTC treatment for the indigenous people, thereby, promoting the positive emotions of the indigenous elderly.

This study analyzes the effect of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). A panel analysis was conducted by combining 21 years of data (from 2000 to 2020) from 38 OECD countries. Life expectancy and avoidable mortality were set as the dependent variables; gross domestic product and poverty gap were set as the independent variables; body mass index, consumption, smoking rate, healthcare personnel, number of beds in health service facilities, national medical expenses, and unemployment were set as control variables. First, economic growth and poverty gap significantly affect life expectancy and avoidable mortality. It has been confirmed that to resolve health inequality, growth during growth and distribution must be prioritized. Second, it has been confirmed that as the poverty gap increases, life expectancy increases and the avoidable mortality rate decreases. A mechanism different from the existence of a medical security system targeting the lowest class or an increase in the welfare of society worked. In conclusion, as a policy proposal to alleviate health inequality, this study suggests that policy intervention is necessary to block or alleviate the negative impact of income inequality in health care policies.

U.S. Spanish-speaking populations experienced gaps in timely COVID-19 information during the pandemic and disproportionate misinformation exposure. Brigada Digital de Salud was established to address these gaps with culturally-tailored, Spanish-language COVID-19 information on social media. From May 1, 2021-April 30, 2023, 495 Twitter, 275 Facebook, and 254 Instagram posts were published and amplified by 10 trained community health workers. A qualitative content analysis was performed to characterize topics and formats of 251 posts. To assess reach and engagement, page analytics and advertising metrics for 287 posts were examined. Posts predominantly addressed vaccination (49.45%), infection risks (19.12%), and COVID-related scientific concepts (12.84%). Posts were educational (48.14%), and aimed to engage audiences (23.67%), promote resources (12.76%), and debunk misinformation (9.04%). Formats included images/text (55.40%), carousels (27.50%), and videos (17.10%). By June 9, 2023, 394 Facebook, 419 Instagram, and 228 Twitter followers included mostly women aged 24-54. Brigada Digital reached 386,910 people with 552,037 impressions and 96,868 engagements, including 11,292 likes, 15,240 comments/replies, 9,718 shares/retweets, and 45,381 video play-throughs. The most engaging posts included videos, trending topics, and music or audio-narration. This community-based model to engage Spanish-speaking audiences on social media with culturally-aligned content to counter misinformation shows promise for addressing public health threats.

As of July 7, 2022, the total number of confirmed cases caused by COVID-19 has reached 544,324 million, and the total number of 6.333 million deaths (WHO). Older people were globally the most vulnerable during the pandemic. This paper examined the mortality and psychological crisis of older people during the pandemic in four cities, namely Wuhan, Milan, London, and Hong Kong. The selection of cities was based on different degrees of social connectedness of older people and chronologically to cover the whole period of the outbreak from January 2020 to August 2022. Older people in Milan and Wuhan tended to rely on the close family relationship during times of crisis. Meanwhile, older people in Hong Kong and London were more dependent on social services. Both quantitative and qualitative approaches were employed to analyze the situations of older people under different government responses and the strengths and weaknesses of respective healthcare systems. Government reports and official statistics were used to illustrate the seriousness of each city's COVID-19 outbreak while stories reported by the press, NGOs, and journal articles were used to reflect the reactions of the older people. Interactions of social culture, health care provisions, and government responses to the pandemic were discussed from the perspective of health welfare regimes. On one hand, results showed that governments have not learned from the experiences of other countries. On the other hand, older people have not successfully coped with the life-threatening stress by breaking institutional boundaries and redefining cultural norms.

More than twenty-five years ago the Global Solar UV index (UVI) has been introduced as a simple means of visualizing the intensity of ultraviolet radiation and to alert people to the need for sun protection. In our survey among directors of 436 kindergartens in southern Germany we investigated the level of awareness and knowledge about the UVI as well as the practical consequences for sun protection in kindergartens. Less than half of the directors (n=208, 47.7%) had ever heard of the UVI, and only a small minority of them (n=34, 8.7%) used the daily UVI information to adapt sun protective measures in their kindergartens. Detailed knowledge about the UVI was a rarity among the respondents. The proportion of respondents with self-perceived detailed UVI knowledge was five times higher than actual knowledge assessed by an in-depth structured interview using open-ended questions about the UVI (14.2% vs. 2.8%). No clear relationship of UVI awareness, knowledge, and use to directors' age and gender was found. The UVI-related variables also showed no association with directors' knowledge of risk factors for skin cancer and their attitudes towards tanned skin. Overall, the results paint a sobering picture regarding the penetration of the UVI into sun protection policies of German kindergartens. Future public health campaigns should target increasing awareness and understanding of the UVI as well as its importance for sun protection of children.

Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL of assisting nurses in public health. Methods: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to Nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. Results: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. Work Process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and Health problems. Conclusions: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general.

Background: Supportive supervision has lately been gaining traction in various national health systems as an effective way of boosting the performance of community health workers in a constructive and sustainable way. However, not much is known about the basis/mandate of supportive supervision and its approach in maternal and child health programs in India. The current analysis contributes to a clearer understanding of the paradigms within which supportive supervision is envisioned to operate within India and identifies potential strengths and areas requiring attention. Method: Document analysis of implementation documents such as guidelines/ operational manuals/operationalization modules/ training modules of nationally implemented maternal and child health programs, with data extraction according to a pre-determined domain-based template. Results: Many of the documents reviewed do not mention supportive supervision at all. In the few documents where supportive supervision is mentioned, the paradigms within which it is supposed to operate (who will do it, when will it be done, how to do it, training and logistic support, reporting formats, etc.) have not been clearly identified in most programs. Conclusion: Even though supportive supervision is being increasingly identified as an effective way of performative improvement in national health programs in India, more effort needs to be put into identifying and enforcing the tenets of supportive supervision in practice, in order to bring about the desired change.

Medical records contain many terms which are difficult to process. Our aim in this study is to allow the visual exploration of the information in medical databases where the texts presents a large number of syntactic variations and abbreviations, through an interface which facilitates content identification, navigation and information retrieval. We propose the use of multi-term tag clouds as content representation tools and as assistants for the browsing and querying tasks. The tag cloud generation is achieved through a novelty mathematical method that allows related terms to remain grouped together within the tags To evaluate this proposal, we have used a database with 24,481 records. 23 expert users in the medical field were tasked to complete a survey to evaluate the generated tag clouds properties and we obtained a precision of 0.990, a recall of 0.870 and a F1score of 0.904 in the evaluation of the tag cloud as an information retrieval tool. The main contribution of this approach is that we automatically generate a visual interface over the text capable of capturing the semantics of the information and facilitating access to medical records.

The COVID-19 pandemic has contributed to mental health problems worldwide. Nurses are particularly prone to stress because they directly care for individuals with suspected or confirmed cases of COVID-19. The aim of this study is to explore the association between the mental health promotion strategies used by nurses during the coronavirus disease (COVID-19) outbreak and their symptoms of depression, anxiety, and stress, and to compare the strategies and symptoms of mental health nurses and non-mental health nurses. Cross-sectional study was conducted with a sample of 821 nurses. Portuguese nurses demonstrated high symptoms of depressive symptoms, stress, and anxiety. Healthy eating, physical activity, rest between shifts, maintaining social contacts, verbalizing feelings/emotions, and spending less time searching for information about COVID-19 are associated with better mental health. Mental health nurses have less depression, anxiety, and stress, and use more strategies to promote mental health than other nurses. We consider it important to promote nurses’ mental health literacy by encouraging them to develop skills and strategies aimed at improving their resilience and ability to deal with difficult situations while caring for the population.

Background: Recent disasters have demonstrated gaps in employers’ preparedness to protect employees and promote their well-being in the face of emergencies and disasters affecting the workplace and their communities. Total Worker Health (TWH), a comprehensive perspective developed by the National Institute for Occupational Safety and Health, is a helpful framework for addressing employer preparedness. It includes attention to health and safety at work, and the promotion of the health and well-being of the employee in the context of social determinants of health, such as work-life balance. Methods: TWH concepts, including the domains of TWH and the TWH Hierarchy of Controls, were investigated for their relevance to protecting employees and promoting their well-being during and after crises such as weather disasters, pandemics, and acts of terrorism. Building upon TWH concepts, an employer preparedness framework and model is proposed. Findings: The Model emphasizes upstream prevention, workplace-community linkages, social and economic impacts, and employer leadership through a cyclical planning process. Conclusions/Application to Practice: The Model can assist employers in advancing their preparedness for all hazards through self-assessment and planning agendas based upon the proposed domains.

Shelter-in-place aimed at slowing COVID-19 transmission has altered nature accessibility patterns, creating quasi-experimental conditions to assess if retracted nature contact and perceived nature deprivation influences physical and emotional wellbeing. We measure through survey methods how pandemic mandates limiting personal movement and outdoor nature access effect self-assessed nature exposure, perceived nature deprivation, and subsequent flourishing as measured by the Harvard Flourishing Index. Results indicate that perceived nature deprivation strongly associates with neighborhood nature contact, time in nature and access to municipal nature during the pandemic, after controlling for shelter-in-place mandates, job status, household composition, and sociodemographic variables. Our hypothesis that individuals with strong perceived nature deprivation under COVID-19 leads to diminished wellbeing proved true. Interaction models of flourishing showed positive modification of nature affinity with age and qualitative modification of nature deprivation with race. Our results demonstrate the potential of local nature contact to support individual wellbeing in a background context of emotional distress and social isolation, important in guiding public health policies beyond pandemics.

The School Fruit and Vegetables Scheme (SFVS) implemented by the European Union during 2009/10 aims to improve the diet of school children and to support agricultural markets and environmental sustainability. The objective of this study was to characterize the SFVS implementation in Spain (2009-2017). A descriptive, longitudinal, observational and retrospective study was carried out based on document analysis of annual strategies of the SFVS. We studied the average budget for the EU, the number of students enrolled, the cost of the SFVS by student and by day, the duration of the SFVS, the quantity of fruits and vegetables (FV) per student, the variety of FV, the inclusion of local, seasonal and organic foods, and the education activities (EA). The results were studied by autonomous community (AC). The budget increased from 7.4 million euros in 2009/10 to 14.4 in 2016/17. Since 2014/15, the increase came from EU funds, the number of students increased from 18% in 2009 to 20% in 2016. The quantity of FV went from 2,579 to 4,000 tons, duration increased from 9.8 to 19.6 days and the variety of fruits and vegetables increased from 20 to 21 and from 5 to 6 respectively. In AC there were important variations in EA, in the number of enrolled students (7.4% to 45.6%), in the cost per student (2.3€ to 28€) and in the duration in days (5.6 to 70 days). The inclusion of local, seasonal and organic foods was identified in 5 of the 8 years studied. The development and reach of the SFVS in Spain is still insufficient to influence dietary patterns and health in the school population. However, the SFVS has generated an economic market for agricultural production.

Non-typhoid salmonellosis is a common and problematic foodborne zoonotic disease in which pork and pork products can be an important potential source of infection. In order to prevent this disease important efforts to monitor the situation in the main source, livestock, are conducted in most developed countries. In the European Union EFSA and ECDC compile information at the member state level, even though important differences in production systems and surveillance systems exist. Here, Salmonella surveillance systems in one of the main sources of foodborne salmonellosis, swine, and humans in Spain were reviewed to identify potential gaps and discuss potential ways of integration under a One Health approach. Despite the extensive information generated through the surveillance activities source attribution can be only routinely performed through ad-hoc outbreak investigations, and national reports on human outbreaks do not provide sufficiently detailed information to gain a better understanding of the epidemiology of the pathogen. Human and animal monitoring of Salmonella would benefit from a better exchange of information and collaboration. Analysis of spatio-temporal trends in livestock and humans could help to identify likely sources of infection and to target surveillance efforts in areas with higher prevalence or where specific strains are found.

Migrants are mainly employed in "3D Jobs" dirty, dangerous, difficult, characterized by monotony, intense rhythms, in sectors at higher risk as construction, heavy industry, agriculture. Aim of this study is to elaborate a systematic review, in order to identify the main occupational risks and occupational diseases of this category. Research included articles published from 2013 to 2018 on the major online databases (PubMed, Cochrane Library and Scopus), using a combination of some keywords (migrant workers, expatriates, physical health, diseases, illnesses, travel, travelers, work and occupational). The online search indicated 1.109 references. We excluded 977 studies, because unrelated to physical health and 64 due to duplication. They were analyzed 68 articles, including 6 reviews and 62 original article. The main risk emerged are to developing infectious diseases, metabolic cardiovascular diseases and to manifesting a lower quality of life, in particular due to difficulties in accessing local health services. It will be crucial to implement the role of occupational medicine in order to introduce multilevel interventions designed to prevent work-related injuries and illnesses and to promote healthier working environments.

Admission and discharge diagnoses of in-hospital patients are often in discord. Incorrect admission diagnoses are related to increased cost of care and patient safety. Additionally, due to the seasonality of many conditions, this discord may vary across the year. In this paper, we used medical claims data to develop a methodological framework that examines these differences, for Medicare beneficiaries. We provide examples for pneumonia, a condition with seasonal implications, and aneurysm, where early detection can be life-saving. Following a Bayesian approach, our work quantifies and visualizes with time series plots the degree that any clinical condition is correctly diagnosed upon admission. We examined differences in weekly intervals, during a calendar year. The mean length of stay and hospital charges were furthermore compared between matching and non-matching {admission, discharge Dx} pairs, and 95% confidence intervals of the difference of means were estimated. We applied Statistical Process Control methods and then visualized differences, for the hospital charges and the length of stay, per week, with time series plots. Our methodology and the visualizations underline the importance of a rigorous and non-delayed diagnostic process upon admission since there are significant implications in terms of hospital outcomes and cost of care.

The purpose of this study was to report data analysis results from the International Health Regulations (2005) Ship Sanitation Certificates (SSC), recorded in the European Information System (EIS). International sea trade and population movements by ships can contribute to the global spread of diseases. SSC are issued to ensure the implementation of control measures if public health risk exists on board. EIS designed according to the World Health Organization (WHO) “Handbook for Inspection of Ships and Issuance of SSC”. Inspection data were recorded and SSC issued by inspectors working at European ports were analysed. From July 2011-February 2017, 107 inspectors working at 54 ports in 11 countries inspected 5579 ships. Of these, there were 29 types under 85 flags (including 19 EU flags). As per IHR (2005) 10,281 Ship Sanitation Control Exception Certificates (SSCEC) and 296 Ship Sanitation Control Certificates (SSCC) were issued, 74 extensions to existing SSC were given, 7565 inspection findings were recorded, and 47 inspections were recorded without issuing an SSC. The most frequent inspection findings were the lack of potable water quality monitoring reports (23%). Ships aged ≥12 years (Odds Ratio, OR = 1.77, 95%Confidence Intervals, CI = 1.37–2.29) with an absence of cargo at time of inspection (OR = 3.36, 95%CI = 2.51–4.50) had a higher probability of receiving an SSCC, while ships under the EU flag had a lower probability of having inspection findings (OR = 0.72, 95%CI = 0.66–0.79). Risk factors to prioritise the inspections according to IHR were identified by using the EIS. A global information system, or connection of national or regional information systems and data exchange, could help to better implement SSC using common standards and procedures.

Genomic medicine is moving from research to the clinic. There is a lack of evidence about the impact of genomic medicine interventions on health outcomes. This is due in part to a lack of standardized outcome measures that can be used across different programs to evaluate the impact of interventions targeted to specific genetic conditions. The eMERGE Outcomes working group (OWG) developed measures to collect information on outcomes following the return of genomic results to participants for several genetic disorders. These outcomes were compared to outcome intervention pairs for genetic disorders developed independently by the ClinGen Actionability working group (AWG). In general, there was concordance between the defined outcomes between the two groups. The ClinGen outcomes tended to be higher level and the AWG scored outcomes represented a subset of outcomes referenced in the accompanying AWG evidence review. eMERGE OWG outcomes were more detailed and discrete, facilitating collection of relevant information from health records. This paper demonstrates that common outcomes for genomic medicine interventions can be identified. Further work is needed to standardize outcomes across genomic medicine implementation projects and make these publicly available to enhance dissemination and assist in making precision public health a reality.

AI-driven tools can identify nursing students' strengths and weaknesses, thus enabling the development of customized learning plans that target specific areas for improvement. This targeted approach can enhance knowledge retention and skill development, resulting in better prepared healthcare professionals. Nursing students are required to overcome their own psychological stress during their internship in order to understand sick children’s emotional reactions, as well as to be able to interact and communicate with such children. The application of AI picture-based teaching e-books helps nursing students to understand how to use therapeutic games to improve communication with sick children. A comparison of the differences between nursing teachers’ self-efficacy scores and nursing students’ application of AI picture-based teaching e-books (experimental group) and narrative handouts (control group) was achieved via therapeutic games to deal with sick children’s fear of medical examinations and treatments. In addition, a comparison was also conducted on the differences between the impact of the self-efficacy of the experimental group and that of the control group in dealing with sick children’s behavioral responses with respect to fears of medical examinations and treatments. This study is a quasi-experimental study, in which the self-efficacy scores of 30 nursing students were collected and analyzed in both the experimental group and the control group before and after intervention in dealing with sick children’s behavioral responses to fears of medical examinations and treatments. It was found that the self-efficacy score of the experimental group was higher than that of the control group (β coefficient is 0.356) when assessing the self-efficacy scores and behavior of the experimental and control groups in dealing with sick children’s fears of medical examinations and treatments through one-way analysis of covariance (one-way ANCOVA), moreover, a statistically significant difference (p < 0.05) was observed. The experimental group’s score of behavioral responses to the fears of sick children to examinations and treatments was lower than that of the control group (β coefficient was -1.540), wherein a statistically significant difference (p < 0.05) was shown. The self-efficacy of the experimental group in dealing with sick children’s fears of medical examinations and treatments had a statistically significant impact on the sick children’s behavioral responses to the fear of medical examinations and treatments (p < 0.05). In addition, the higher the self-efficacy scores of the experimental group in dealing with sick children’s fear of medical examinations and treatments, the lower the sick children’s behavioral responses to fears of medical examinations and treatments (the β coefficient was -0.914), the control group’s self-efficacy scores in dealing with sick children’s fears of medical examinations and treatments did not have a statistically significant impact on the sick children’s behavioral responses to fears of medical examinations and treatments (p > 0.05). This study proves that the application of AI picture-based teaching e-books by nursing teachers is more effective than narrative handouts in improving nursing students’ self-efficacy when using therapeutic games to deal with, as well as reduce, sick children’s fears of medical examinations and treatments.

The integration of Augmented Reality (AR) in e-commerce has emerged as a transformative development, reshaping how consumers interact with online retail environments. This research explores the impact of AR on e-commerce by examining its effects on consumer behavior, purchase decisions, and overall shopping experience. Through a series of interviews with industry experts, the study uncovers key insights into how AR enhances product visualization, leading to improved consumer confidence and a reduction in return rates. The immersive and interactive nature of AR applications has been shown to significantly increase consumer engagement and conversion rates, as users are able to interact with products in a virtual setting that simulates real-world experiences. Despite these advantages, the research also highlights several challenges associated with AR implementation, including the high costs of development and maintenance, difficulties in integrating AR technology with existing e-commerce platforms, and concerns regarding privacy and data security. The study further explores the varying applications of AR across different sectors within e-commerce, such as fashion, furniture, and cosmetics, each benefiting from unique AR functionalities. Looking ahead, the potential for AR to be enhanced by emerging technologies like Artificial Intelligence and the Internet of Things is discussed, with implications for future advancements in the field. Overall, the research demonstrates that while AR offers significant benefits for enhancing online shopping experiences, addressing its associated challenges is crucial for its successful and widespread adoption.

This qualitative research explores Supplier Relationship Management (SRM) practices within the e-commerce fashion industry, aiming to uncover key strategies and their impacts. Through semi-structured interviews with supply chain managers, procurement officers, and supplier representatives, critical themes emerged: communication, trust, risk management, sustainability, and digital technologies. Effective communication, characterized by transparency and regular updates, emerged as pivotal for aligning expectations and resolving issues promptly. Trust-building practices, including fair dealings and formal agreements, were essential in fostering long-term partnerships, reducing transaction costs, and enhancing collaboration. Robust risk management strategies, such as supplier diversification and contingency planning, were identified as crucial for mitigating disruptions and ensuring supply chain resilience. Sustainability was highlighted as a strategic imperative, driven by ethical sourcing and environmental standards, supported by technologies like blockchain for transparency. The transformative role of digital technologies—supply chain management software, blockchain, IoT, and data analytics—was evident in enhancing visibility and decision-making across global supply chains. Viewing suppliers as strategic partners, rather than mere vendors, promoted collaborative innovation and mutual growth. Despite challenges like cultural differences and regulatory complexities, opportunities exist to enhance SRM through integrated best practices. By prioritizing effective communication, trust-building, risk management, sustainability, and digital innovation, companies can strengthen supplier relationships, optimize supply chain performance, and achieve competitive advantage in the e-commerce fashion sector.

This qualitative study explores the pivotal role of Supplier Relationship Management (SRM) in enhancing resilience within e-commerce supply chains. In an era marked by rapid digital transformation and global interconnectedness, the resilience of supply chains has become a strategic imperative for organizations striving to maintain operational efficiency and meet customer expectations. Through semi-structured interviews with supply chain managers, procurement officers, and strategic sourcing specialists across diverse industries, this research investigates the strategies, challenges, and outcomes associated with SRM practices. Findings reveal that effective communication and collaboration are fundamental to successful SRM, fostering trust, transparency, and responsiveness in supplier relationships. Strategic risk management through proactive identification and mitigation strategies enables organizations to navigate uncertainties such as economic fluctuations and geopolitical tensions. SRM implementation yields significant organizational benefits, including improved supply chain efficiencies, enhanced product quality, and increased customer satisfaction. However, challenges such as technological complexities, cultural differences among global suppliers, and regulatory compliance issues underscore the need for adaptive strategies and digital investments. The integration of digital technologies such as AI and blockchain enhances SRM effectiveness by enabling real-time data exchange, predictive insights, and decision-making capabilities. Ultimately, SRM emerges as a cornerstone of sustainable growth and competitive advantage in e-commerce, empowering organizations to optimize supply chain performance and resilience amidst dynamic market conditions.

This study explores the strategic importance of leveraging supplier relationships for competitive advantage in the e-commerce industry. Strong supplier relationships are crucial for enhancing operational efficiencies, cost management, quality assurance, innovation, sustainability, and overall supply chain resilience. Through collaborative partnerships, e-commerce companies can streamline logistics, reduce costs, ensure consistent product quality, and foster innovation through joint development initiatives. Ethical sourcing and sustainable practices play a pivotal role in supplier relationship management (SRM), aligning with consumer expectations and enhancing brand reputation. Advanced technologies such as AI, blockchain, and IoT further transform SRM practices by improving transparency, efficiency, and decision-making capabilities across the supply chain. The study also discusses challenges in managing global supplier relationships, emphasizing the importance of effective communication, cultural sensitivity, and strategic risk management. By addressing these challenges and nurturing trust-based relationships with suppliers, e-commerce firms can navigate market complexities and achieve sustainable growth. This research provides insights for e-commerce companies seeking to optimize their supplier relationships and maintain competitive advantage in a dynamic market environment.

This qualitative study explores the intricacies of building sustainable supplier relationships in the e-commerce sector, focusing on best practices and strategic approaches. Through in-depth interviews with procurement managers, supply chain experts, and supplier representatives, the research identifies four critical themes: trust, technology integration, ethical practices, and performance measurement. Trust is found to be the foundation of effective supplier relationships, fostering open communication and collaboration, which are essential for addressing challenges and co-creating solutions. The integration of digital technologies such as supply chain management software, blockchain, and the Internet of Things significantly enhances transparency, decision-making, and operational efficiency, providing a competitive edge. Ethical practices, including adherence to fair labor standards and environmental sustainability, are increasingly crucial as consumer and regulatory expectations evolve, necessitating alignment between e-commerce companies and their suppliers. Performance measurement and continuous improvement are vital for maintaining quality and efficiency, with clear metrics and regular evaluations driving constructive feedback and optimization of supply chain processes. The study underscores the interdependence of these elements in fostering resilient and adaptable supplier relationships. The findings offer practical guidance for e-commerce businesses and suppliers, emphasizing the need for a holistic approach to supplier management that balances trust, technology, ethics, and performance. This approach not only enhances operational effectiveness but also ensures the long-term sustainability of supplier relationships in the dynamic e-commerce landscape. The research contributes to the theoretical understanding of supplier relationship management, providing a comprehensive framework for future studies and practical applications in the e-commerce industry.

This qualitative research explores Supplier Relationship Management (SRM) strategies within the context of e-commerce customization, aiming to understand how businesses effectively manage relationships with suppliers to meet personalized consumer demands. Through semi-structured interviews with industry professionals, key themes such as trust, communication, technological integration, strategic alignment, sustainability, and collaboration emerged as critical factors influencing SRM effectiveness. Trust was found to be foundational, fostering cooperation and commitment between e-commerce businesses and suppliers through transparent interactions. Effective communication and the integration of advanced technologies like AI and blockchain enhanced operational efficiency and innovation capabilities, enabling businesses to deliver tailored customer experiences. Strategic alignment between businesses and suppliers proved essential for shared success and mutual benefit, while sustainability practices increasingly shaped consumer preferences and brand reputation. Collaboration facilitated joint innovation and accelerated product customization, underscoring the importance of partnerships in achieving strategic goals. However, challenges including supply chain complexity, managing consumer expectations, and regulatory compliance highlighted the need for continuous improvement and adaptive strategies. Overall, this research contributes valuable insights for e-commerce businesses seeking to optimize SRM strategies, enhance supply chain efficiency, and navigate the complexities of customization in a competitive digital marketplace. By leveraging trust, communication, technology, strategic alignment, sustainability, and collaboration, businesses can effectively meet evolving consumer demands and achieve sustainable growth.

This qualitative study explores the transformative role of Supplier Relationship Management (SRM) in the context of e-commerce, focusing on the integration of digital technologies and evolving supplier interactions. As digital advancements such as artificial intelligence, blockchain, data analytics, cloud computing, and the Internet of Things (IoT) reshape traditional SRM practices, e-commerce companies are experiencing significant improvements in efficiency, transparency, and collaboration. This research employs semi-structured interviews, document analysis, and case studies to examine the impact of these technologies on SRM, identify key collaborative practices, and assess risk management strategies. Findings indicate that digital integration enhances decision-making, streamlines operations, and fosters deeper, trust-based supplier relationships. AI facilitates predictive analytics and automates processes, while blockchain provides transparency and reduces fraud. Data analytics supports informed sourcing decisions and risk mitigation, and cloud platforms improve real-time collaboration. IoT enhances supply chain visibility, allowing for better inventory management. Despite these benefits, challenges such as high implementation costs, integration difficulties, data privacy concerns, and security risks remain significant barriers. Collaboration practices, including joint development, shared resources, and coordinated marketing, contribute to innovation and mutual growth, emphasizing the need for effective communication and trust. Risk management strategies, such as scenario planning and supplier diversification, are crucial for maintaining supply chain resilience. Strategic alignment between e-commerce companies and suppliers, including goal congruence and capability matching, is essential for seamless coordination and competitive advantage. The study underscores the importance of a holistic approach to SRM, integrating technology, collaboration, risk management, and strategic alignment to navigate the complexities of supplier relationships in the digital age. These insights provide a framework for e-commerce companies to optimize their SRM practices and achieve sustainable growth in a dynamic marketplace.

The production of recombinant proteins in Escherichia coli is often challenged by cytoplasmic expression due to proteolytic degradation and inclusion body formation. Extracellular expression can overcome these problems by simplifying downstream processing and improving protein yields. This study aims to compare the efficiency of two Bacillus subtilis chitosanase signal peptides in mediating extracellular secretion in E. coli. We identified a naturally occurring mutant signal peptide (mCsn2-SP) from B. subtilis CH2 chitosanase (CH2CSN), which is characterized by a deletion of six amino acids in the N-region relative to the signal peptide (Csn1-SP) from B. subtilis CH1 chitosanase (CH1CSN). The CH1CSN and CH2CSN genes were cloned into the pET-11a vector and protein secretion was evaluated in E. coli BL21(DE3) host cells. Expression was induced with 0.1 mM and 1 mM IPTG at 30°C for one and three days. CH2CSN showed higher secretion levels compared to CH1CSN under all experimental conditions, especially with 0.1 mM IPTG induction for 3 days, which resulted in a 2.37-fold increase in secretion. These results suggest that signal peptide deletion variants may have an effect on protein secretion efficiency and help to further understand the function of signal peptides.

Shared e-scooters are gaining popularity as a solution for first and last-mile connectivity in urban areas. This study conducted in Doha, Qatar, aimed to understand how weather and land use patterns affect e-scooter usage, utilizing various datasets. Given the novelty of micromobility systems in Qatar and their sensitivity to the local hot and humid climate, the study employed a comprehensive analytical approach. Analysis revealed that e-scooter demand spikes on weekends, particularly in the afternoon. Influential land use factors include proximity to universities and employment centers, while a higher presence of Qatari females in an area correlates with reduced usage, pointing to cultural influences. Weather conditions, especially humidity and extreme temperatures, significantly impact e-scooter demand. The study employed the Density-Based Spatial Clustering of Applications with Noise (DBSCAN) algorithm for trip clustering and the Random Forest (RF) algorithm to model trip counts, considering temperature and humidity. Insights showed humidity as a critical predictor of hourly e-scooter trip counts. These findings underscore the importance of considering weather, land use, the relationship between land use characteristics and weather variations, and finally cultural factors in optimizing e-scooter services. By integrating data analysis and machine learning, the study offers valuable insights for enhancing urban mobility and transportation planning in GCC countries, promoting sustainable urban mobility.

The installation of electric vehicle supply equipment (EVSE) increases demand and peak loads, potentially straining existing energy distribution infrastructure. Dispersed and inadequately planned placement of charging points (CPs) can disrupt the electrical grid, surpass contracted demand thresholds, and require infrastructure upgrades, thereby incurring unfeasible costs for Distribution System Operators (DSOs). In this context, it is necessary to recognize the role of business models in enabling effective electrification of the transportation sector. In response to these challenges, this paper introduces a novel e-mobility hub management strategy, tailored for implementation in the Brazilian context. The proposed strategy revolves around a microgrid configuration encompassing dispatchable and photovoltaic generation, a battery energy storage system (BESS), EVSE infrastructure, and local loads. Moreover, this centralized controller facilitates the implementation of dynamic pricing and demand-response mechanisms, integral to business models seeking to integrate EVSE into the distribution grid. To validate the efficacy of the proposed solution, hardware-in-the-loop (HIL) simulations of the microgrid system are conducted. These simulations, incorporating the centralized controller, serve as a tool for assessing system performance and viability before on-site equipment deployment. Finally, this paper concludes with the insights gleaned from test analysis and its discussion through a selection of the most expressive scenarios, including islanded and connected operation modes.

he paper offers an innovative cooking utensil design for remote, isolated, and even peri-urban communities at a low price, with high reliability and simple construction. It can alleviate energy poverty and improve food security. This utensil uses only local solar energy directly and allows comfortable indoor cooking. This paper provides the design principles of a solar cooker/frying pan or generic heater, based on a PV panel or a plurality of them, which are directly connected to a plurality of Positive Thermal Coefficient (PTC) resistors to match the power. PTCs are nowadays produced in massive quantities and are widely available at low cost. The proposed device does not require an electronic controller or a battery for its operation. The aim is for family use, although the design can be easily scaled to a larger size or power, maintaining its simplicity. Electric heating inside or attached to the cooking pot, plus the temperature self-limiting effect of PTCs, allows for thermally insulating the cooking pot from its outside using ordinary materials. Insulation en-hances energy efficiency during cooking and keeps cooked food warm for a long time. Clean development would receive a significant impulse with its application. A simple mathematical model describes its functioning and states guidelines for adequate design. The results indicate a successful proof of concept and high efficiency both for water and oil as representatives of cooking.

The wind flow patterns and pressure distribution around a plus-shaped building are significantly influenced by the dimensions of its re-entrant corners and the overall building height. The present study aims to find the wind effects and study of the pressure distribution with different flow patterns. Plan area of the building is around 300 square meter while the height of the building is 50 meters by keeping the equal length of the re-entrant corners. The research is performed using ANSYS CFX academic version and the results are depicted in various forms such as pressure coefficient (Cpe), stream lines in both vertical as well as in specific surface and pressure contours. The analysis is carried out by varying the wind incident angles, from 0° to 90° at the interval of 15°. The building dimension are scale down to perform the test on length scale of 1:100. Since the considered building model exhibits symmetry along both the axes, present study mostly emphasis on examining re-entrant corners located in the building. This method yields valuable information about how air circulates and how pressure is distributed across a broad spectrum of wind angles. This study provides valuable insights into flow circulation and pressure distribution for a wide range of wind angles.

A two-step, one-pot synthesis of 3-substituted 1H-dibenzo[e,g]indazoles in good to high yields via a LiOtBu-promoted intramolecular cyclization of 2’-alkynyl-biaryl-2-aldehyde N-tosylhydrazones, formed in situ by the reactions of 2’-alkynyl-biaryl-2-aldehydes with p-methylbenzenesulfonohydrazide was developed. Two kinds of hydrogen bonds forming in several products were observed in DMSO-d6 solution in 1H NMR spectroscopic data, which were assigned to the formation of solvated products and dimers of products, supported by the studies of density functional theory (DFT).

Recurrent infections after root canal treatments often involve Enterococcus faecalis, a microorganism closely associated with therapy failures due to its biofilm production, survival in nutrient-deprived conditions, and antibiotic tolerance. Essential oils (EOs), which display anti-inflammatory, antimicrobial, and antibacterial properties, exhibit inhibitory effects on the growth of many microorganisms including E. faecalis. This study assessed the in vitro efficacy of combining antibiotics (Gentamicin 1.5mg/ml, Streptomycin 2.5 mg/ml, Ampicillin 5 mg/ml, and Kanamycin 2.5 mg/ml) with Cinnamon (1.25% to 5%) or Clove (25% to 50%) EOs using disk diffusion tests. Disks were treated with EOs-only, antibiotics-only, or EO-antibiotic combinations, placed on BEA agar plates, incubated for 24 hours, and zones of inhibition were measured against E. faecalis. Results showed robust growth inhibition by cinnamon and clove EOs across all tested concentrations. Furthermore, there were synergistic antimicrobial effects when gentamicin, streptomycin and kanamycin were combined with 2.5% and 50% concentrations of cinnamon and clove EOs, respectively, leading to significant growth inhibition of E. faecalis by 139% to 193% compared to using antibiotics or EOs alone. Clove EO showed positive synergism with three antibiotics (gentamicin, streptomycin, and kanamycin) whereas cinnamon EO showed synergism with two antibiotics (streptomycin and kanamycin). These findings suggest that combining cinnamon and clove EOs with aminoglycoside antibiotics can significantly reduce the expansion of E. faecalis compared to antibiotics alone. Further in vivo studies should determine the safety, efficacy, and treatment duration, with the potential to reduce antibiotic dosages and associated toxicity while preventing recurrent infections.

The paper discusses the experience of implementing an efficient economic management system at the University of Vigo in Spain. This system, which focuses on managing secondments, aims to minimize bureaucracy and standardize economic procedures for various staff groups. By adopting a qualitative methodology and utilizing content analysis, the study compares the University of Vigo's fully digital administrative procedure with other universities in the CRUE network. The results show significant time and cost savings due to this implementation. The improved traceability and information for users support the administrative change, and the positive environmental impacts highlight the commitment to a more sustainable approach. The paper's originality lies in demonstrating how this approach enhances efficiency, reduces costs, and improves sustainability within a Spanish public administration setting.

Higher education teaching staff members need to build a scientifically accurate and comprehensive understanding of the function of the brain in learning to optimize teaching and achieve excellent student learning. An international consortium developed a professional development six-module course on educational neuroscience and online community of practice applying design thinking. A mixed methods research design was employed to investigate the attitudes of thirty-two (N=32) participating academics using a survey comprising eleven closed and open questions. Data analysis methods included descriptive statistics, correlation, generalized additive model and grounded theory. The overall evaluation demonstrated a notable satisfaction level with regard to the quality of the course. Given the power of habits, mentoring and peer interactions are recommended to ensure the effective integration of theoretical neuroscientific evidence into teaching practice.

A twelve-week feeding trial was conducted to investigate the effect of dietary supplementation of a functional immunostimulant mixture (FIM; nucleotides, β-glucan and vitamins C and E) on growth, feed utilization, innate immunity, digestive enzyme activity, hematological parameters, intestinal morphology and inflammatory gene expression of olive flounder, Paralichthys olivaceus. A fish meal-based basal diet (control) was formulated and three other diets were prepared by incorporating 0.5, 1.0 and 1.5% FIM into the basal diet (HB0.5, HB1.0 and HB1.5, respectively). Five replicate groups of fish (26.3 ± 0.1 g) were fed one of the experimental diets. Inclusion of 1.5% FIM in the diet significantly enhanced growth and feed utilization. Significantly higher plasma hemoglobin, hematocrit, total protein levels and lower plasma glucose level were observed in HB1.5 group. Total immunoglobulin content, lysozyme, nitroblue tetrazolium, myeloperoxidase, superoxide dismutase, glutathione peroxidase and catalase activities and immune-related gene expressions of toll-like receptor and perforin were significantly increased at highest inclusion level. FIM supplementation significantly increased villus height and goblet cell counts. Anti-inflammatory gene expression was significantly upregulated at a 1.5% level. Dietary supplementation of 1.5% of FIM could improve growth and feed utilization, immune, hematological and histomorphological parameters of olive flounder.

In epithelia, breakdown of tensional homeostasis is closely associated with E-cadherin dysfunction and disruption of tissue function and integrity. In this study, we investigated the effect of E-cadherin mutations affecting distinct protein domains on tensional homeostasis of gastric cancer cells. We used micropattern traction microscopy to measure temporal fluctuations of cellular traction forces in AGS cells transfected with the wild-type E-cadherin or with variants affecting the extracellular, the juxtamembrane, and the intracellular domains of the protein. We focused on the dynamic aspect of tensional homeostasis, namely the ability of cells to maintain a consistent level of tension, with low temporal variability around a set point. Cells were cultured on hydrogels micropatterned with different extracellular matrix (ECM) proteins to test whether the ECM adhesion impacts cell behavior. A combination of Fibronectin and Vitronectin was used as a substrate that promotes the adhesive ability of E-cadherin dysfunctional cells, whereas Collagen VI was used to test an unfavorable ECM condition. Our results showed that mutations affecting distinct E-cadherin domains influenced differently cell tensional homeostasis, and pinpointed the juxtamembrane and intracellular regions of E-cadherin as the key players in this process. Furthermore, Fibronectin and Vitronectin might modulate cancer cell behavior towards tensional homeostasis.

We are calling for a paradigm shift in engineering education. In times of the Fourth Industrial Revolution (“4IR”), a myriad of potential changes is affecting all industrial sectors leading to increased ambiguity that makes it impossible to predict what lies ahead of us. Thus, incremental culture change in education is not an option any more. The vast majority of engineering education and training systems, having remained mostly static and underinvested in for decades, are largely inadequate for the new 4IR labor markets. Some positive developments in changing the direction of the engineering education sector can be observed. Novel approaches of engineering education already deliver distinctive, student centered curricular experiences within an integrated and unified educational approach. We must educate engineering students for a future whose main characteristics are volatility, uncertainty, complexity and ambiguity. Talent and skills gaps across all industries are poised to grow in the years to come. The authors promote an engineering curriculum that combine timeless didactic tradition, such as Socratic inquiry, project-based learning and first-principles thinking with novel elements (e.g. student centered active and e-learning by focusing on the case study and apprenticeship pedagogical methods) as well as a refocused engineering skillset and knowledge. These capabilities reinforce engineering students’ perceptions of the world and the subsequent decisions they make. This 4IR engineering curriculum will prepare engineering students to become curious engineers and excellent communicators better navigating increasingly complex multistakeholder ecosystems.

The novel coronavirus pneumonia epidemic is still raging around the world. Therefore, during the period of a global pandemic, maintaining the normal circulation of medicine and health fields is the key to fight against the epidemic. This paper based on relevant data such as the export volume of cross-border e-commerce in Hangzhou, China from 2015 to 2019, the article uses system dynamics modeling to explore the impact of overseas warehouse services on cross-border e-commerce export transactions. Studies have shown that the introduction of overseas warehouses has significantly improved customer satisfaction and improved the quality of cross-border logistics services, which has a positive impact on cross-border e-commerce export transactions. Through sensitivity analysis, it can be seen that under the same conditions, the efficiency of customs clearance has the greatest impact on overseas warehouse services. Therefore, when allocating various investments in overseas warehouses, you can favor the customs clearance process to enhance the competitiveness of the cross-border e-commerce market and provide a feasible experience for healthcare supplies export from cross-border e-commerce.

Rare earths are classified as most important and critical material for US economy and defense by Congress and a mandate has been set to increase their in-house production, domestic resource utilization and decrease reliance on foreign resources and reserves. They are widely available in earth crust as ore (bastnaesite (La, Ce)FCO₃, monazite, (Ce, La, Y, Th)PO₄, and xenotime, YPO₄), but their so-called economic reserves are sparsely located geographically. They may be produced by various means such as beneficiation (physical, chemical, mechanical, or electrical), reduction (direct or indirect), electrolysis (of aqueous or molten / fused single or mixed salt systems) at high temperature or hydrometallurgy. Out of these, direct reduction also known as metallothermic reduction (La and Ca reduction) is mostly utilized. Its variant, high temperature electrowinning of fused salts is also practiced widely. These processes are material and application specific. In this study, author will employ thermodynamics (Ellingham diagrams, free energy of formation, reduction potential, Nernst equation, Pourbaix (E_h-pH) diagrams, E-pO^-2 diagrams), kinetics and energetic of a chemical reaction (chemical metallurgy) to reduce rare earth oxide / salt to rare earth metals (REO/RES – REM). It is shown that materials and energy requirement vary greatly depending on type of mineral ore, production facility, and beneficiation / mineral processing method selected. Aim is to reduce dependence on coal deposits. It is anticipated this route will be able to produce rare earths with > 35% yield and > 98% purity which be described in subsequent studies and patents.

The COVID-19 outbreaks have caused universities all across the globe to close their campuses and forced them to initiate online teaching. This article reviews the pedagogical foundations for developing effective distance education practices, starting from the assumption that promoting autonomous thinking is an essential element to guarantee full citizenship in a democracy and for moral decision making in situations of rapid change, which has become a pressing need in the context of a pandemic. In addition, the main obstacles related to this new context are identified, and solutions are proposed according to the existing bibliography in learning sciences.

Wound infections evidently appeared in times of World War I that accounted a significant mortality and morbidity rate among injured soldiers. Currently, around 11 million people worldwide require medical treatment for wound infections and 300,000 die every year due to untreated wound infection. The extensive use of antibiotics to treat wound infection leads to emerging new microbial strains that are resistant to many antibiotics. There is a growing concern on the emergence and re-emergence of drug-resistant pathogens such as multi-resistant bacterial strains. Hence, the development of new antimicrobial compounds or the modification of those that already exist to improve antibacterial activity is a high priority area of research. During the past few decades, nanotechnology has arisen with new promising technology for synthesis of nanobiomaterials. Metallic nanoparticles (NPs) are considered as new alternative treatment with superior antibacterial activity. In this study, new formulation of titanium oxide (TiO2) NPs with different sizes were synthesized and characterized. Genotoxicity, mutagenicity and antibacterial activities of TiO2 NPs against the causative agents of wound infection were investigated. Antibacterial activity of TiO2 NPs was conducted against three ATCC ® bacterial strains: methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli and Pseudomonas aeruginosa. The results clearly illustrate a superior antibacterial activity of all newly formulated TiO2 NPs against the most causative agents of wound infection. Most of our TiO2 NPs showed non-genotoxic and non-mutagenic results at the maximum concentrations. Findings of this study will enhance the future of the therapeutic strategies against the resistant pathogenic strains that cause wound infections.

With the development of information technology and the popularization of mobile devices, collecting various types of customer data such as purchase history or behavior patterns became possible. As the customer data being accumulated, there is a growing demand for personalized recommendation services that provide customized services to customers. Currently, global e-commerce companies offer personalized recommendation services to gain a sustainable competitive advantage. However, previous research on recommendation systems has consistently raised the issue that the accuracy of recommendation algorithms does not necessarily lead to the satisfaction of recommended service users. It also claims that customers are highly satisfied when the recommendation system recommends diverse items to them. In this study, we want to identify the factors that determine customer satisfaction when using the recommendation system which provides personalized services. To this end, we developed a recommendation system based on Deep Neural Networks (DNN) and measured the accuracy of recommendation service, the diversity of recommended items and customer satisfaction with the recommendation service. The experimental results of is the study showed that both recommendation system accuracy and diversity would have a positive effect on customer satisfaction. These results can further improve customer satisfaction with the recommendation system and promote the sustainable development of e-commerce.

The USDA-FSIS considers mechanically-tenderized beef as ‘non-intact’ and a food safety concern because of the potential for translocation of surface E. coli O157:H7 into the interior of the meat that may be cooked ‘rare or medium-rare’ and consumed. We evaluated 14 potential spray interventions on E. coli O157:H7-inoculated lean beef wafers (~10⁶ CFU/cm² , n=80) passing through a spray system (18 sec dwell time, ~40 PSI) integrated into the front end of a Ross TC-700MC tenderizer. Inoculated and processed beef wafers were stomached with D/E neutralizing broth and plated immediately, or were held in refrigerated storage for 1-, 7-, or 14 days prior to microbial plating. Seven antimicrobials that showed better performance in preliminary screening on beef wafers were selected for further testing on beef subprimals in conjunction with blade tenderization. Boneless top sirloin beef subprimals were inoculated at ~2 x 10⁴ CFU/cm² with a four-strain cocktail of Escherichia coli O157:H7 and passed once, lean side up, through an integrated spray system and blade tenderizer. Core samples obtained from each subprimal were examined for the presence/absence of E. coli O157:H7. Absence of E coli O157:H7 translocated into core samples correlated with the ability of the antimicrobials to reduce bacterial levels on the surface of beef prior to blade tenderization.

Specific nutrients including n-3 long chain polyunsaturated fatty acids (LCPUFAs), flavonoids, vitamin A, D and E are considered to possess protective properties on human health by impacting on immunological reactions. An ‘inflammation-suppressive’ effect appears to be the common denominator of the beneficial effects of most of these dietary components which may protect against the development of chronic immune disorders such as allergy. However, the majority of these promising data are from preclinical studies such as animal disease models, as the majority of clinical studies only indicate associations. PUFAs, especially n-3 LCPUFAs, have been shown to interact with both the sensitization as well as the effector phase in food allergy. However, it should be noted and realised that PUFAs are highly susceptible to lipid oxidation. Flavonoids and fat-soluble vitamins both contain anti-inflammatory properties and are able to act as anti-oxidants as well. Here, we explore the anti-allergic properties of PUFAs, flavonoids and fat-soluble vitamins in order to create an overview and, more importantly, suggest a strategy to target food allergies using these components and combinations thereof. Dietary n-3 LCPUFAs and the above mentioned micronutrients are promising anti‐allergy agents capable of influencing the allergic immune response through multiple and different biological pathways.

The healthcare sector in Kuwait has been nurtured for many decades by the government where the Ministry of Health (MoH) controls up to 80 percent of the country’s health services. General and specialized public hospitals represent a significant proportion of health expenditures in Kuwait; amidst dwindling health resources, a declining global oil market in an oil-dependent welfare state, and a heavy reliance on a non-national clinical workforce. Although healthcare services in public sector hospitals are at highly subsidized rates, causing private sector involvement in healthcare to be considerably low, the growing demands for private delivery of care burgeoned participation of private hospitals in Kuwait, and improving hospital efficiency and productivity is more critical and timelier than ever. This paper aims to analyze public health system efficiency and hospital performance in the State of Kuwait, where we begin by evaluating the input-oriented technical efficiency (TE) of MoH hospitals in 2015-2019 and identifying potential areas for efficiency improvement by exploring influencing institutional and environmental factors. Over the five years between 2015 and 2019, TE in MoH hospitals has decreased by an average of 2.98% solely based on technical regress, where the six MoH general hospitals reported a pooled mean efficiency of 86.58%, and the nine sampled MoH specialized hospitals had a five-year pooled average of 65.47% efficiency. MoH policymakers should focus on improving allocative efficiency in the public health system, and healthcare policy reforms should focus on strengthening management structures in Kuwait’s public hospitals to improve production efficiency and financial sustainability.

Functional health literacy is the ability to read, write, and speak about health. Functional health literacy events can nudge the development of children’s health identity when using valid and reliable reading materials that portray the “what, where, when, why, and with whom” to eat nutritious foods and be physically active. Children who lack social role models for healthy eating and physical activity may also lack development in language and motor skills. Therefore, literacy-rich environments are needed when developing cognitive-motor language skills with children. Children with obesogenic body frames can gain from the production of childcentric health narratives that draw upon the Habits of Mind and Habits of Health© Model to produce Electronic Texts for Health Literacy©. When health professionals plan and implement functional health literacy events so children can read, write, and speak about their own health, new behavioral patterns and routines emerge into performances of understanding. Constructivist pedagogical approaches can help children to create health narratives using multimodal language while practicing health literacy skills as a foundational impetus to health behaviors. Children who struggle with obesity can also gain social agency when writing with peer partners who serve as supportive collaborators when developing interactive health literacy.

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

AbstractIntroduction: Consistent utilization of institutional delivery service reduces maternal morbidity and mortality. However, service utilization could in turn influenced by the women’s satisfaction with the service provided by the health care providers. In addition, their satisfactions with the institutional delivery service remains understudied. Assessment of the maternal satisfaction with maternal health service is a major input to improve maternal health services. Objective: To assess the maternal satisfaction with maternal health service and its predictors among the women who gave birth in last 12 months in Darara district, Southern Ethiopia.Methods: A community-based cross-sectional study was done using a mixed method among the sample of 520 women in Darara district, South Ethiopia from June 1-30, 2023. A systematic and purposive sampling procedure was utilized to choice the study subjects. A structured, validated and pretested interview-administrated questionnaire and in-depth interview were utilized to collect the data. The data were entered into Epi data version 3.1 and analyzed using SPSS version 25. The chi-square (X²) test was utilized to determine the overall association between independent and dependent variables. Both bi-variable and multivariable binary logistic regression analyses were conducted. Important assumptions of the binary logistic regression were checked to be satisfied. The coding and analysis of the qualitative data were done using thematic content analysis technique by Atlas-Ti software and presented in narratives. Results: The total maternal satisfaction with maternal health service was 55.2% (95% CI = 50.8-59.4). The identified predictors of maternal satisfaction were distance from household to health post (AOR = 3.59; 95% CI= 1.71 - 7.55), absence of preparation of HEWs during procedure (AOR= 2.87; 95% CI = 1.74 - 4.74), acceptability of the HES by HHs (AOR= 2.18; 95% CI = 1.14 - 4.18), having a reliable communication method with HEWs (AOR = 3.47; 95% CI = 1.77 - 6.79) and received training on the model family (AOR= 2.48, 95% CI= 1.86 - 2.57). These quantitative results were supported by the individual, organizational, socio-demographic and cultural qualitative findings. Conclusions: This study indicated that 55.2% of women were satisfied with maternal service.Distance from household to health post, absence of preparation of HEWs during procedure, acceptability of the Health Extension Service (HES) by household, having a reliable communication method with HEWs and received training on the model family were significant predictors of maternal satisfaction. The interventions to increase maternal satisfaction with HES need to focus on household-based acceptability of them and their reliable communication method in planning and implementing the services. Similarly, expansion of training of model family in the community would increase maternal satisfaction levels.

Abstract: Background: Viral hepatitis B and C (HBV and HCV) pose significant public health challenges globally, particularly in Nigeria, where access to healthcare and treatment affordability are major concerns. This study aims to identify sociodemographic and clinical predictors of health insurance coverage among patients with HBV and HCV in Nigeria. Methods: A cross-sectional facility-based study was conducted at two secondary hospitals in Nasarawa State, Nigeria. Par-ticipants included patients diagnosed with HBV, HCV, or both and are > 18 years old. Data were collected using a structured questionnaire covering sociodemographic and clinical information, health insurance details, and economic impact. Logistic multivariate regression analysis was used to analyze the relationship between sociodemographic/clinical variables and health insurance status. Results: Out of 295 participants included in the final analysis, 67.1% had health insur-ance, primarily covering hepatitis screening and vaccination. Being aged 31-45 years (adjusted Odds Ratio [aOR]: 5.72, 95% Confidence Interval [CI]: 1.4 - 23.28, p = 0.02), having post-secondary education (aOR: 11.73, CI: 4.09 - 33.66, p < 0.001), and being HIV-positive (aOR: 2.86, CI: 1.02 - 8.02, p = 0.046) were significant predictors of health insurance coverage. Being unemployed significantly reduced the likelihood of having health insurance (aOR: 0.04, CI: 0.01 - 0.11, p < 0.001).Conclusions: This study reveals high insurance coverage among patients seeking viral hepatitis services in Nasarawa state, Nigeria and provides critical insights into the sociodemo-graphic predictors of health insurance coverage. It also highlights the need for the expansion health insurance benefit package that covers for viral hepatitis diagnosis and treatment, espe-cially for the younger adults, unemployed and less educated populations. This should be followed with adequate budgeting and policy implementation monitoring efforts, which are crucial for Nigeria's journey towards universal health coverage and elimination of viral hepatitis.

The aim of this study is to describe a research protocol of a multi-country randomized controlled trial to investigate the effect of a smartphone CBT stress management program on improving depression and other health- and work-related outcomes among hospital nurses in Vietnam and Thailand during the COVID-19 epidemic as a part of the COCONATS project. The study is a two-arm, parallel randomized control trial. Hospital nurses (N = 1,500) will be recruited in Vietnam and Thailand, and those who meet the criteria will be randomly allocated to the intervention or control (treatment as usual) group. A seven-week, seven-module smartphone-based stress management program will be developed to teach CBT skills. The intervention group will participate in the program for 10 weeks. Depression as the primary outcome will be measured using the DASS21 at baseline and in 3- and 6-month follow-up surveys. A mixed model repeated measures analysis will be used to test the intervention effect in the total combined sample, on an intention-to-treat basis. This is the first study to investigate the effectiveness of a self-guided smartphone CBT program on improving depression among hospital nurses using a RCT design in South-East Asian middle-income countries during the COVID-19 pandemic.

Background: Passive drinking is prevalent in adolescents worldwide, but its prevalence and harm are understudied. Methods: Secondary students (n=5840, grades 7-12) from 23 selected schools in Hong Kong participated in the survey from 2015-16. Students reported the harm of passive drinking, perceived health status, Patient Health Questionnaire-2, Perceived Stress Scale-4, perceived happiness, family health, happiness, and harmony in the questionnaire. The associations were analyzed using multivariable logistic regression (odds ratio, OR) and linear regression (unstandardized coefficient, b), adjusted for confounders. Results: 29.1% (95% CI 27.8 to 30.5%) of students experienced passive drinking in the past 30-day. Past 30-day parental passive drinking was associated with a higher level of depressive symptoms (AOR 1.63, 95% CI 1.26 to 2.10), stress (adjusted b 0.76, 0.42 to 1.10), and lower level of perceived happiness (adjusted b -0.52, -0.72 to -0.33). Past 30-day parental passive drinking was associated with a lower level of family health (adjusted b -1.39, 95% CI -1.66 to -1.11), family happiness (adjusted b -1.36, -1.64 to -1.08), and family harmony (adjusted b -1.40, -1.70 to -1.10). Conclusion: Passive drinking was associated with poorer mental health, family wellbeing, and lower level of happiness among Hong Kong Chinese adolescents.

COVID-19 pandemic has the potential to adversely affect the mental health of healthcare workers (HCWs). The public healthcare system in Greece was already facing serious challenges at the outset of the outbreak following years of austerity and an escalating refugee crisis. The multi-center, cross-sectional study aims to assess the levels and associated risk factors of anxiety, depression, traumatic stress and burnout of frontline staff in Greece. A total of 464 HCWs in six reference hospitals completed a self-administered questionnaire comprising of sociodemographic and work-related information and psychometric scales. The proportion of HCWs with symptoms of moderate/severe depression, anxiety and traumatic stress were 30%, 25% and 33% respectively. Burnout levels were particularly high with 65% of respondents scoring moderate/severe in Emotional Exhaustion, 92% severe in Depersonalization and 51% low/moderate in Personal Accomplishment. Predictive factors of adverse psychological outcomes included fear, perceived stress, risk of infection, lack of protective equipment and low social support. The psychological burden associated with Covid-19 in healthcare professionals in Greece is considerable with more than half experiencing at least mild mental health difficulties. Findings signal the need for immediate organizational and individually tailored interventions to enhance resilience and support wellbeing under pandemic conditions.

Background: To inform global health policies and resources planning, this paper analyzes evolving trends in physical rehabilitation needs, using data on Years Lived with Disability (YLDs) from the Global Burden of Disease Study (GBD) 2017. Methods: Secondary analysis of how YLDs from conditions amenable to physical rehabilitation have evolved from 1990 to 2017, for the world and across countries of varying income levels. Linear regression analyses were used. Results: A 66.2% growth was found in estimated YLD Counts amenable to physical rehabilitation: a significant and linear growth of more than 5.1 billion YLDs per year (99%CI: 4.8–5.4; r² = 0.99). Low-income countries more than doubled (111.5% growth) their YLD Counts amenable to physical rehabilitation since 1990. YLD Rates per 100,000 people and the percentage of YLDs amenable to physical rehabilitation also grew significantly over time, across locations (all p > 0.05). Finally, only in high-income countries Age-standardized YLD Rates significantly decreased (p < 0.01; r² = 0.86). Conclusions: Physical rehabilitation needs have been growing significantly in absolute, per-capita and in percentage of total YLDs, globally and across countries of varying income level. In absolute terms, growths were higher in lower income countries, wherein rehabilitation is under-resourced.

Is the amount of “greenness” within a 250-meter, 500-meter, 1000-meter or a 2000-meter buffer surrounding a person’s home a good predictor of their physical health? The evidence is inconclusive. We reviewed Web of Science articles that used geographic information systems buffer analyses to identify trends between physical health, greenness, and distance within which greenness is measured. Our inclusion criteria were: (1) use of buffers to estimate residential greenness; (2) statistical analyses that calculated significance of the greenness-physical health relationship; and (3) peer-reviewed articles published in English between 2007 and 2017. To capture multiple findings from a single article, we selected our unit of inquiry as the analysis, not the article. Our final sample included 260 analyses in 47 articles. All aspects of the review were in accordance with PRISMA guidelines. Analyses were independently judged as more, less, or least likely to be biased based on the inclusion of objective health measures and income/education controls. We found evidence that larger buffer sizes, up to 2,000m, better predicted physical health than smaller ones. We recommend that future analyses use nested rather than overlapping buffers to evaluate to what extent greenness not immediately around a person’s home (i.e., within 1,000-2,000m) predicts physical health.

Background: Online survey-based observational cross-sectional study aimed at elucidating experience and attitudes of unstructured population regarding diagnostic imaging. Methods: Invitations to participate were distributed using mixed-mode design to deidentified residents aged 18 years and older. Main outcome measures included morbidity structure and incidence of diagnostic imaging administrations. Results: Respondents (n = 1069) aged 44.3 ± 14.4 years; 32.8% suffered from cardiovascular diseases (CVD); 9.5% had chronic respiratory pathology; 28.9% considered themselves healthy. Respondents with COVID-19 history (49.7%) reported higher rates of computed tomography (CT) (p &lt; .0001), magnetic resonance imaging (MRI) (p &lt; .001), and ultrasound (p &lt; .05). COVID-19 history in CVD respondents shifted imaging administrations towards CT and MRI (p &lt; .05). Every tenth respondent received MRI, CT, and ultrasound on paid basis; 29.0% could not pay for diagnostic procedures; 13.1% reported unavailable MRI. Professional status significantly affected the pattern of diagnostic modalities (p &lt; .05). MRI and CT availability differed between respondents in urban and rural areas (p &lt; .0001). History of technogenic events predisposed responders to overestimate diagnostic value of fluorography (p &lt; .05). Conclusions: Preparedness to future pandemics requires development of community-based outreach programs focusing on people's awareness regarding medical imaging safety and diagnostic value.

Background: Artificial intelligence can help improve the quality of healthcare by analyzing vast amounts of data and providing more effective and personalized treatment plans. Researchers are working on developing AI-powered solutions that can help improve the outcomes of patients. Objective: To explore the potential of AI in improving healthcare outcomes and patient experience. Results: The study suggests that AI can improve healthcare efficiency and patient outcomes but cannot fully replace human healthcare professionals. AI can assist healthcare professionals in their work, leading to better resource utilization and improved patient care. However, there is still a need for human healthcare professionals to oversee AI systems and provide empathy and personalized care to patients. Conclusion: While there is immense potential for AI in healthcare, it is not yet feasible to replace human healthcare workers. Instead, it should be viewed as a tool that can help improve the efficiency and effectiveness of human healthcare.

Background/Objectives: Dengue is an arbovirus caused by a virus. It is an endemic infectious and occurs in warmer climates. It is not uncommon for the disease to be asymptomatic. However, the severe form can also be triggered and require intensive care. In this sense, patients present a wide variety of symptoms, which can trigger comorbidities such as arthritis, hematologic diseases, liver diseases, kidney diseases, autoimmune diseases, and, mainly, diabetes and hypertension. Among the symptoms, the presence of fever, myalgia, headache, nausea, vomiting, leukopenia, petechiae, retroorbital pain, arthralgia, rashes, skin eruptions, cardiovascular symptoms, respiratory symptoms and, depending on the severity, the presence of hemorrhages may occur. Methods: 235 patients' anonymized records from a secondary hospital were analyzed. Ethics approval was obtained and no patients’ consent was needed. Statistical analysis used frequency distributions and Chi-square tests, with SPSS software. Results: Similar to other studies, our results show that dengue can lead to complications. Furthermore, there was no significant difference in the distribution of the proportion of symptoms between patients with positive and negative serology. However, there was a significant association between age group and symptoms of fever and myalgia, with the occurrence of fever decreasing with increasing age and myalgia being more frequent in adults and less frequent in those &lt;10 years old. Conclusions: Dengue can lead to complications, with fever becoming less common and muscle pain increasing as people age. Climate change could spread dengue to new areas. To address this, we need better vaccines and more effective mosquito control.

The rapid evolution of digital payment systems has significantly transformed the retail industry, reshaping how transactions are processed and enhancing the overall shopping experience. This research explores the adoption of digital payment technologies in retail settings, focusing on the motivations, challenges, benefits, and impacts associated with their implementation. Retailers are increasingly driven by the need to meet consumer demands for convenience and speed, as well as to gain a competitive edge in a saturated market. Digital payment systems, including mobile wallets, contactless payments, and online payment gateways, have become essential tools for retailers seeking to streamline operations and improve customer satisfaction. The study highlights several key findings, including the challenges related to technical integration, security concerns, and cost implications. Technical difficulties in integrating new payment systems with existing point-of-sale infrastructure, coupled with the need for robust security measures, present significant obstacles. Despite these challenges, the long-term benefits of digital payments, such as increased transaction volumes, higher average transaction values, and valuable data insights, often outweigh the initial investment and ongoing costs. The research also underscores the positive impact of digital payments on customer behavior, noting improvements in transaction speed, convenience, and overall satisfaction. Furthermore, the findings reveal variations in the impact of digital payment systems across different retail settings, including large department stores, independent retailers, and e-commerce businesses. The ability to tailor digital payment solutions to the specific needs of each retail environment is crucial for maximizing benefits and ensuring successful implementation. Overall, the study provides a comprehensive understanding of the role of digital payment systems in modern retail and offers insights into the future trajectory of these technologies.

This qualitative study explores the role of Supplier Relationship Management (SRM) in optimizing inventory within the context of e-commerce. Through semi-structured interviews with e-commerce managers and supply chain experts, the study investigates the strategies, challenges, and outcomes associated with SRM practices. Key findings highlight the critical importance of strategic partnerships with suppliers, emphasizing trust, transparency, and goal alignment as foundational elements for effective SRM. Participants underscored the transformative impact of technological advancements, including advanced analytics and blockchain technology, in enhancing supply chain visibility, optimizing inventory levels, and improving operational agility. However, the study also identifies challenges in SRM implementation, such as cultural differences, regulatory compliance, and geographical distances, which require proactive management strategies. Innovation emerges as a key driver of competitive advantage in e-commerce, facilitated through collaborative R&D initiatives and co-innovation with suppliers. Strategic alignment with organizational goals is crucial for integrating SRM practices with broader business objectives, including operational efficiency and risk mitigation. Recommendations include adopting integrated SRM strategies that leverage technological innovations while maintaining a focus on relationship-building and sustainability. Enhanced supplier performance monitoring, proactive risk management, and the integration of sustainable practices are proposed to strengthen supplier relationships and enhance supply chain resilience. By addressing these insights, e-commerce firms can optimize inventory management, drive innovation, and achieve sustainable growth in the digital economy.

This study investigates the critical role of Supplier Relationship Management (SRM) in enhancing the e-commerce user experience. In an increasingly competitive digital marketplace, effective SRM practices are essential for optimizing supply chain operations and meeting customer expectations. The research employs a qualitative approach, combining semi-structured interviews with industry stakeholders, extensive literature review, and case studies to explore various dimensions of SRM. Key findings reveal that strategic supplier selection criteria, including quality, cost efficiency, reliability, innovation, and sustainability, are pivotal in ensuring a robust and adaptable supply chain. Effective communication practices, such as transparency, frequent updates, and digital tools, foster strong supplier relationships and enable timely issue resolution. Performance management strategies, centered on KPI monitoring and continuous improvement, support operational excellence and customer satisfaction. Risk management practices, including diversification, contingency planning, and advanced analytics, are crucial for mitigating disruptions and ensuring supply chain resilience, as highlighted by the challenges posed during the COVID-19 pandemic. Technological integration with blockchain, AI, IoT, data analytics, and automation enhances efficiency, transparency, and decision-making capabilities in SRM. Furthermore, the study underscores the evolving integration of sustainability and ethical sourcing into SRM strategies, reflecting broader corporate responsibility goals. Ultimately, this research contributes to understanding how effective SRM strategies drive competitive advantage in e-commerce by enhancing supply chain reliability, responsiveness, and customer-centricity. As e-commerce continues to evolve, adapting and innovating SRM practices will be vital for companies aiming to sustain growth and meet the dynamic demands of global markets.

This qualitative study explores the dynamics of Supplier Relationship Management (SRM) and its impact on innovation within the e-commerce sector. Through in-depth interviews and documentary analysis of three case study firms known for their innovative practices, the study examines how collaborative SRM practices influence innovation outcomes, organizational resilience, and competitive advantage in dynamic market environments. Key themes include the pivotal role of trust, transparency, and joint problem-solving in fostering effective SRM relationships, enabling knowledge sharing and co-development of innovative products and services. Innovation outcomes observed encompass product innovation, process improvements, and technological advancements facilitated by close collaboration between e-commerce firms and their suppliers. Challenges such as managing supplier diversity, navigating regulatory complexities, and mitigating geopolitical risks highlight the complexities and strategic imperatives of SRM implementation in global supply chains. The study also emphasizes the transformative role of digital technologies, including real-time data exchange, predictive analytics, and agile supply chain management, in enhancing SRM effectiveness and innovation capabilities. Strategic alignment with organizational goals and market strategies further enhances the impact of SRM, enabling firms to prioritize innovation initiatives, allocate resources effectively, and sustain growth amidst economic uncertainties. The findings contribute to theoretical understanding and practical insights into SRM strategies that promote innovation excellence and competitive positioning within e-commerce. The implications for practice underscore the importance of fostering collaborative supplier relationships, investing in digital transformation, and adopting proactive strategies to manage risks and regulatory compliance.

This qualitative study explores Supplier Relationship Management (SRM) in the context of digital transformation within e-commerce businesses, focusing on the implications of emerging digital technologies. Through semi-structured interviews and documentary analysis, the study examines how organizations leverage technologies like artificial intelligence (AI), blockchain, and Internet of Things (IoT) to enhance SRM practices. Findings reveal that digitalization enables improved operational efficiencies, real-time data analytics, and expanded supplier networks through platforms such as Amazon Business and Alibaba. Strategic shifts are noted towards collaborative supplier relationships, emphasizing joint innovation, technology co-investment, and shared risk management strategies. However, the implementation of digital SRM strategies presents challenges, including data privacy concerns, integration complexities, cybersecurity threats, and regulatory compliance issues. Organizations must navigate these challenges by developing robust governance frameworks and cybersecurity protocols to protect sensitive information and ensure regulatory adherence. Key performance indicators (KPIs) such as supplier performance, cost savings, innovation impact, risk management effectiveness, and sustainability integration are critical for evaluating the success of digital SRM initiatives. Strategically, businesses are advised to prioritize leadership commitment, cross-functional collaboration, and continuous learning to optimize digital SRM practices effectively. Future research should explore emerging trends in digital SRM, investigate technological impacts on supplier dynamics and organizational performance, and examine ethical considerations in digitalization. By integrating these insights into strategic decision-making, businesses can enhance supplier relationships, mitigate operational risks, and achieve sustainable growth in the global marketplace.

This qualitative research investigates the influence of Corporate Social Responsibility (CSR) on Supplier Relationship Management (SRM) within the e-commerce sector. Through semi-structured interviews and secondary data analysis, the study explores motivations, challenges, impacts, and strategic outcomes of integrating CSR practices into supplier relationships. Motivations for adopting CSR include ethical considerations, regulatory compliance, and meeting stakeholder expectations, reflecting a strategic alignment with corporate values and societal demands. Challenges such as resource constraints, regulatory complexities, and cultural differences highlight operational hurdles and strategic considerations e-commerce firms face in implementing CSR initiatives effectively. The study reveals that CSR enhances trust, collaboration, and risk mitigation within e-commerce supply chains through transparent communication, shared values, and ethical practices. Strategically, CSR contributes to enhanced brand equity, competitive advantage, and long-term value creation by differentiating firms in competitive markets and attracting socially conscious consumers and investors. However, economic trade-offs, stakeholder divergence, and operational complexities require firms to adopt adaptive strategies that balance short-term financial goals with long-term sustainability objectives. The findings suggest avenues for future research exploring longitudinal impacts of CSR on supplier relationships, cross-sectoral comparisons, and technological advancements in CSR-driven SRM practices. Practically, e-commerce firms should prioritize strategic alignment of CSR initiatives with core business objectives, engage stakeholders in CSR strategy development, and embrace continuous improvement to foster ethical conduct, stakeholder trust, and sustainable business practices.

Supplier Relationship Management (SRM) plays a pivotal role in enhancing delivery performance within the e-commerce sector, yet understanding its nuanced impacts remains crucial for optimizing operational efficiencies and customer satisfaction. This qualitative research explores the intricate dynamics of SRM in e-commerce, focusing on strategic alignment, technological integration, trust, collaboration, and risk management as key determinants of delivery reliability. Through in-depth interviews and thematic analysis, the study reveals that strategic alignment of supplier capabilities with firm objectives is fundamental for maintaining a responsive and synchronized supply chain. Technological integration, including AI-driven analytics and blockchain applications, emerges as critical for real-time monitoring and adaptive decision-making, thereby improving delivery accuracy and efficiency. Trust and collaboration are identified as essential pillars for building resilient supplier relationships, fostering transparent communication and joint problem-solving. Effective risk management practices, such as supplier diversification and contingency planning, mitigate disruptions and ensure consistent delivery performance. Despite these benefits, challenges such as technological adoption barriers, cultural differences, communication complexities, resource constraints, and supplier reliability issues persist, necessitating strategic interventions. Recommendations include investing in advanced SRM technologies, promoting cultural understanding, enhancing communication protocols, allocating adequate resources, and fostering collaborative initiatives with suppliers. These strategies aim to overcome challenges and optimize SRM practices, ultimately enhancing delivery performance and competitiveness in the e-commerce landscape.

This qualitative study explores how businesses are adapting their Supplier Relationship Management (SRM) strategies to address the challenges and capitalize on the opportunities presented by evolving e-commerce trends. Through in-depth interviews with key industry stakeholders, the research investigates the integration of advanced technologies such as artificial intelligence (AI), blockchain, and the Internet of Things (IoT) into SRM practices. Findings reveal that these technologies enhance efficiency, transparency, and responsiveness within supply chains, enabling businesses to navigate complexities such as supply chain dynamics, fluctuating consumer demand, and regulatory compliance. The study identifies effective strategies employed by businesses, including enhancing communication channels with suppliers, diversifying supplier bases, and investing in technological advancements. These strategies enable businesses to mitigate risks, improve collaboration, and drive innovation, thereby maintaining competitive advantage in the digital marketplace. Collaborative practices such as joint product development, shared risk management, and co-investment in technology emerge as critical drivers of successful SRM. Ultimately, this research contributes to a deeper understanding of SRM in the context of e-commerce, offering insights into how businesses can optimize their supply chain operations amidst technological disruptions and market fluctuations. The findings underscore the importance of proactive adaptation and strategic alignment with suppliers to foster resilient and agile supply chains. As e-commerce continues to evolve, businesses must leverage these insights to refine their SRM strategies and sustain growth in an increasingly competitive environment.

The period of the COVID-19 pandemic resulted in a rapid development of innovative education methods, in particular using e-learning and remote work tools. The effects of this development are also post-pandemic changes in formal teaching regulations, in particular in higher education, allowing classes and lectures to be carried out with Blended Learning or Flipped Classroom methods. This paper provides information about a case study of implementing ICT technologies with elements of the mentioned methods in one of the subjects at a technical university. The implemented tools and solutions in the field of e-learning and interactivity are presented, along with information regarding their perception by students during two academic years in the post-COVID-19 period. The analysis of results of these information and student evaluations indicates their generally positive approach to such innovations in the educational path, and at the same time shows significant challenges for teachers to increase the attractiveness and effectiveness of the teaching process and the development of practical, technical skills of students.

This study explores the intricate dynamics of customer-centric supply chains and the pivotal role of marketing innovations in enhancing efficiency and customer satisfaction. Employing a qualitative research methodology, semi-structured interviews were conducted with key stakeholders in supply chain management across various industries, providing rich insights into the practices and perceptions related to customer-centric strategies. The findings highlight the centrality of understanding and anticipating customer needs, which necessitates a cultural shift within organizations to prioritize customer satisfaction at all levels. Digital marketing tools, data analytics, e-commerce platforms, and social media emerged as critical enablers of these customer-centric supply chains, facilitating real-time insights, direct customer engagement, and personalized experiences. The integration of these technologies has led to more accurate demand forecasting, optimized inventory levels, and enhanced agility and responsiveness in operations. Furthermore, the study underscores the importance of collaboration and partnership within the supply chain network, emphasizing joint initiatives and strong relationships with stakeholders as key drivers of improved resource utilization and service levels. Sustainability, entrepreneurship, and emotional intelligence also play significant roles in shaping effective customer-centric supply chains. Sustainable practices meet growing consumer demands for environmental and social responsibility, while an entrepreneurial mindset fosters continuous innovation and competitiveness. Emotional intelligence among leaders and employees enhances trust, conflict resolution, and collaboration, contributing to a positive organizational culture and superior customer satisfaction. Overall, this study provides comprehensive insights and actionable recommendations for businesses seeking to navigate the complexities of customer-centric supply chain management and leverage marketing innovations to achieve sustainable competitive advantage.

E-scooters are a micromobility transportation option for completing short trips. In recent years, many ‎cities welcomed shared e-scooters in an effort to offer more mode choices, increase travelers' ‎convenience, and reduce automobile use in their service areas. However, a knowledge gap still remains ‎regarding the acceptability of shared e-scooters as a transportation option, which motivates additional ‎research on user and non-user preferences and attitudes toward e-scooter use. This study investigates ‎latent variables impacting the adoption of shared e-scooters in urban areas, focusing on mode choice ‎factors and attitudes towards e-scooter use and car use. The study utilizes machine learning (ML) ‎techniques and SHAP analysis to analyze survey data (N=1196) collected from travelers in Washington, ‎D.C., Miami, FL, and Los Angeles, CA, in 2021 and 2022. A comparative analysis is performed to develop ‎comprehensive demographic profiles of e-scooter users. The analysis reveals gender (male), age (25-39 ‎years age group), higher income, and educational background as the most relevant factors toward e-‎scooter use. Attitudinal variations among e-scooter users and non-users underscore the complexity of ‎perceptions toward e-scooter use, with significant differences in mode choice factors and attitudes ‎toward the use of e-scooters and private vehicles. Notably, educational background ranked as a significant ‎factor in Washington, D.C., and Miami, while Factor 3, derived from factor analysis and encompassing car ‎use attitudes and the utilization of technology, emerged as influential in Los Angeles. This research ‎contributes fresh insights into factors shaping e-scooter adoption, offering a foundation for informed ‎urban transportation planning and policymaking. The holistic approach showcased in this study enhances ‎understanding of shared micromobility and its implications for urban mobility.

This study investigated the presence, distribution, and antimicrobial resistance profiles of extend-ed-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in a dairy herd located in Northern Italy. A questionnaire was administered, and the feces of clinically healthy pre-weaned dairy calves, their mothers, and the cows treated for mastitis, waste milk, water, and environmental samples, were collected and inoculated on Chromagar ESBL™ medium. The questionnaire identi-fied several risk factors including administration of waste milk to male calves, lack of routine cleaning of calf feeding and housing equipment, and blanket dry cow therapy. Escherichia coli was identified by MALDI-TOF MS in the feces of 28 of 37 (75.67%) calves, 2 of 3 (66.67%) treated cows, 8 of 14 (57.15%) environmental samples, and the waste milk. Six of 14 (42.85%) environmental samples were also positive for ESBL Acinetobacter baumannii, while all fecal samples were negative. ESBL production was confirmed for all E. coli isolates based on the double disk susceptibility test (DDST), while none were carbapenemase producers. Upon minimal inhibitory concentration (MIC) analysis, all of them showed multiple resistances and were categorized as multi-drug resistant (MDR). This study confirms the widespread presence of MDR, ESBL-E. coli in dairy calves and highlights their diffusion in the farm environment.

The symmetries of a Riemann surface $\Sigma \setminus \{a_i\}$ with $n$ punctures $a_i$ are encoded in its fundamental group $\pi_1(\Sigma)$. Further structure may be described through representations (homomorphisms) of $\pi_1$ over a Lie group $G$ as globalized by the character variety $\mathcal{C}=\mbox{Hom} (\pi_1,G)/G$. Guided by our previous work in the context of topological quantum computing (TQC) and genetics, we specialize on the $4$-punctured Riemann sphere $\Sigma=S_2^{(4)}$ and the \lq space-time-spin' group $G=SL_2(\mathbb{C})$. In such a situation, $\mathcal{C}$ possesses remarkable properties (i) a representation is described by a $3$-dimensional cubic surface $V_{a,b,c,d}(x,y,z)$ with $3$ variables and $4$ parameters, (ii) the automorphisms of the surface satisfy the dynamical (non linear and transcendental) Painlev\'e VI equation (or $P_{VI}$), (iii) there exists a finite set of $1$ (\mbox{Cayley-Picard})+$3$ (\mbox{continuous platonic})+$45$ (\mbox{icosahedral}) solutions of $P_{VI}$. In this paper we feature on the parametric representation of some solutions of $P_{VI}$, (a) solutions corresponding to algebraic surfaces such as the Klein quartic and (b) icosahedral solutions. Applications to the character variety of finitely generated groups $f_p$ encountered in TQC or DNA/RNA sequences are proposed.

This study employed e-Vol DX cone beam computed tomography (CBCT) software to assess dentin remnants in the furcation area of mesial canals in mandibular molars during root canal retreatment (RCR). Four groups (Reciproc®, ProTaper Next®, Race Evo®, Protaper Gold®) were subjected to RCR, and CBCT images were captured before (T1) and after (T2) treatment. Measurements of remaining dentin thickness at 1 mm and 3 mm below the furcation were scrutinized. Results revealed no significant differences in mean thicknesses of mesiobuccal (MB) and mesiolingual (ML) canals at 1 mm and 3 mm from the furcation pre-treatment (T1). Post-treatment (T2) showed analogous findings, with no significant differences in mean thicknesses. However, disparities surfaced between MB and ML canals at both distances, both before and after retreatment. In essence, the evaluated instruments exhibited safety in RCR, implying their appropriateness for use in critical areas of mandibular molars without inducing excessive wear. This study underscores the instruments' reliability in navigating danger zones during RCR, contributing valuable insights for dental practitioners handling complex root canal scenarios in mandibular molars.

The goal of the current study was to discover a novel potential probiotic strain of Lactobacillus spp. with anti-Escherichia coli activity from locally produced yogurt in Tongi, Gazipur, Bangladesh, compare its antagonistic activity with a commercial probiotic mixture of several strains, and approve a novel method for confirming the viability and relative abundance of the microbial community in a probiotic mixer. We carried out 16S sequencing, 16S metagenomics, Transmission Electron Microscopy (TEM) analysis, and other in vitro laboratory experiments to reach this objective. The strain TY-11 was identified as Lactobacillus delbrueckii subsp. indicus (16S sequence accession number OQ652026). It was gram-positive, anaerobic, lactose fermenting, and round-ended rod that typically measured 0.7 to 1.3 µm by 2.2 to 9 µm. In addition to having seven probiotic characteristics, it also showed an antagonistic impact on six different pathogens, but what's more noteworthy is that E. coli was the pathogen it inhibited most strongly (inhibition zone diameter was 18.88±0.18 mm). The most important and ground-breaking finding of this work was determining the probiotic features of a new probiotic strain, TY-11, whose antibacterial activity was virtually as effective as that of the probiotic combination with three different strains. Furthermore, the results of 16S high throughput sequencing and the conventional plate count method demonstrated a strong correlation (0.999) at the genus level, indicating that the use of both of these approaches in combination may be a practical way to assess the relative abundance of the microbial community and their viability in commercially available probiotic blends.

The manuscript presents a novel approach to designing and fabricating a stretchable patch antenna designed for strain sensing and wireless communication of sensing data at the same time. The challenge lies in combining flexible and stretchable textile materials with different physical mor-phologies, which can hinder adhesion among multiple layers when stacked up, resisting the overall stretchability of the antenna. The proposed antenna design overcomes this challenge by incorpo-rating a lattice hinge pattern in the non-stretchable conductive e-textile, transforming it into a stretchable structure. The innovative design includes the longitudinal cuts inserted in both the patch and the ground plane of the antenna, allowing it to stretch along in the perpendicular direction. Implementing the lattice hinge pattern over the conductive layers of the proposed patch antenna in combination with a 2 mm thick Polydimethylsiloxane (PDMS) substrate achieves a maximum of 25% stretchability compared to its counterpart antenna without lattice hinge design. The stretchable textile antenna resonates around a frequency of 2.45 GHz and exhibits a linear resonant frequency shift when strained up to 25%. This characteristic makes it suitable for use as a strain sensor. Ad-ditionally, the lattice hinge design enhances the conformability and flexibility of the antenna compared to a solid patch antenna. The realized antenna gains in the E and H-plane were measured as 2.21 dBi and 2.34 dBi, respectively. Overall, the presented design offers a simple and effective solution for fabricating a stretchable textile patch antenna for normal use or as a sensing element, opening up possibilities for applications in communication and sensing fields.

The E-learning system has achieved great development after the pandemic. In this work, we proposed three artificial intelligence-based enhancements to our linguistic interactive E-learning system from different aspects. Compared with the original phonetic transcription exam system, our enhancements include an MFCC+CNN-based disordered speech classification module, a Transformer-based Grapheme-to-Phoneme converter, and a Tacotron2-based IPA-to-Speech speech synthesis system. This work not only provides a better experience for the users of this system but also explores the utilization of artificial intelligence technologies in the E-learning field and linguistic field.

Ptolemy’s Theorem in Euclidean geometry, named after the Greek astronomer and mathematician Claudius Ptolemy, is well known. We translate Ptolemy’s Theorem from analytic Euclidean geometry into the Poincar´e ball model of analytic hyperbolic geometry, which is based on M¨obius addition. The translation of Ptolemy’s Theorem from Euclidean geometry into hyperbolic geometry is achieved by means of the hyperbolic trigonometry, called gyrotrigonometry, to which the Poincar´e ball model gives rise, and by means of the duality of trigonometry and gyrotrigonometry.

Background and Objectives: Gastric cancer (GC) is one of the most commonly diagnosed cancer and the fourth cause of cancer death worldwide. Personalised treatment improves GC outcomes. A molecular classification is needed to choose the appropriate therapy. A classification that uses on-slide biomarkers and formalin-fixed and paraffin-embedded (FFPE) tissue is preferable to comprehensive genomic analysis. In 2016, Setia et al. proposed an on-slide classification, however this is not in widespread use. We propose a modification of this classification that has six subgroups: GC associated with Epstein-Barr virus (GC EBV+), GC with mismatch repair deficiency (GC dMMR), GC with epithelial-mesenchymal transformation (GC EMT), GC with functional loss of p53 due to mutation (GC p53m), CG with intact p53 (GC p53wt) and GC not otherwise specified (GC NOS). This classification also has provision for biomarkers for current or emerging targeted therapies (Her2, PD-L1 and Claudin18.2). Here we assess the implementation and feasibility of this inclusive working classification. Materials and Methods: We constructed a tissue microarray library from a cohort of 79 resection cases from FFPE tissue archives. We used a restricted panel of on-slide markers (EBER, MMR, E-cadherin, beta-catenin and p53), defined their interpretation algorithms, and assigned each case to a specific molecular subtype. Results: GC EBV(+) cases were 6%, GC dMMR cases were 20%, GC EMT cases were 14%, GC p53m cases were 23%, GC p53wt cases were 29% and GC NOS cases were 8%. Conclusions: This working classification uses markers that are widely available in Histopathology and are easy to interpret. A diagnostic subgroup is obtained for 92% of the cases. The proportion of cases in each subgroup is in keeping with other published series. Widescale implementation appears feasible. A study using endoscopic biopsies is warranted.

An accurate flux measurement of low-energy charged particles trapped in the magnetosphere is necessary for space weather characterization and to study the coupling between the lithosphere and magnetosphere, which allows for the investigation of the correlations between seismic events and particle precipitation from Van Allen belts. In this work, the project of a CubeSat space spectrometer, the Low-Energy Module (LEM), is shown. The detector will be able to perform an event-based measurement of the energy, arrival direction, and composition of low-energy charged particles down to 0.1 MeV. Moreover, thanks to a CdZnTe mini-calorimeter, the LEM spectrometer also allows for photon detection in the sub-MeV range, joining the quest for the investigation of the nature of Gamma-ray bursts. The particle identification of the LEM relies on the ΔE−E technique performed by thin silicon detectors. This multipurpose spectrometer will fit within a 10 × 10 × 10 cm3 CubeSat frame, and it will be constructed as a joint project between the University of Trento, FBK, and INFN-TIFPA. To fulfil the size and mass requirements, an innovative approach, based on active particle collimation, was designed for the LEM; this avoids the heavy/bulky passive collimators of previous space detectors. In this paper, we will present the LEM geometry, its detection concept, the results from the developed GEANT4 simulation, and some characterisations of a candidate silicon detector for the instrument payload.

E-commerce is a rapidly evolving global trend that is having a significant impact on consumer behavior and business strategies. Despite its growing impact, e-commerce adoption by Moroccan firms remains low and research on this topic in this context is scarce. This study aims to fill this gap by investigating the main determinants influencing e-commerce adoption by Moroccan firms. We use logit, probit, and conditional mixed process-probit models to identify the critical factors driving e-commerce adoption. Our results reveal five key findings. First, newer firms that are more open to innovation and change are more likely to adopt e-commerce. Second, firms with a higher proportion of highly educated employees are more likely to adopt e-commerce. Third, the digital skills of new employees do not directly influence the likelihood of e-commerce adoption. Fourth, being listed on digital platforms increases the likelihood of e-commerce adoption. Finally, there is a positive relationship between firms engaged in innovation activities and e-commerce adoption. These findings highlight the need for additional investment in promoting modern organizational practices, reskilling workers, and implementing advanced technologies to facilitate effective e-commerce integration among Moroccan SMEs. By addressing these challenges, Moroccan firms can harness the full potential of e-commerce and contribute to the country’s economic growth and digital transformation.

Composites of Ag and TiO2 nanoparticles on cotton fabrics were synthetized in-situ by sono-chemical and hydrothermal methods achieving the successive formation of Ag-NPs and Ti-NPs directly on the fabric. The impregnated fabrics were characterized by ATR-FTIR spectroscopy, high resolution microscopy (HREM), scanning electron microscopy coupled with Ener-gy-dispersive X-ray spectroscopy (SEM-EDS), Raman, photoluminescence, UV-vis and DRS spectroscopies and by tension tests. Results showed the successful formation and impregnation of NPs on the cotton fabric, with a negligible leaching of NPs after several washing cycles. The photocatalytic activity of supported NPs was assessed by the degradation of methyl blue dye (MB) under solar and UV irradiation revealing improved photocatalytic activity of the Ag-TiO2/cotton composites due to a synergy of both Ag and TiO2 nanoparticles. This behavior is attributed to a diminished electron-hole recombination effect in the Ag-TiO2 cotton samples. The biocide activity of these composites on the growth inhibition of Staphylococcus aureus (Gram+) and Escherichia coli (Gram-) was confirmed, revealing interesting possibilities for the utilization of the functionalized cotton fabric as protective cloth for medical applications.

Background: Studies exploring the possible protective effect of coffee and tea consumption on dementia showed inconsistent results so far. We aimed to investigate whether consumption of tea and different types of coffee at midlife are associated with dementia later in life and, whether sex or ApoE4 influence such association. Methods: We included 7381 participants from the Norwegian HUNT Study. Self-reported questionnaires assessed daily consumption of coffee and tea at baseline. After 22 years, individuals 70 years or older were screened on cognitive impairment. Results: General coffee consumption and tea consumption was not associated with dementia risk. Compared to daily consumption of 0-1 cups of coffee, daily consumption of ≥8 cups of boiled coffee was associated with increased dementia risk in women (OR:1.83, 95% CI: 1.10-3.04, p-value for trend=0.03) and daily consumption of 4-5 cups of other types of coffee was associated with a decrease in dementia risk in only men (OR 0.48, 95% CI: 0.32-0.72, p-value for trend =0.05). Furthermore, the association between boiled coffee and increased dementia risk was only found in ApoE4 non-carriers. Differences by sex or ApoE4 carrier status were not supported by strong statistical evidence for interaction. Conclusion: Type of coffee may play a role in the direction of the association between coffee-drinking habits and dementia later in life.

With the diversified development of media forms, livestreaming e-commerce has become a new sales model. Unlike the traditional sales model, this paper constructs a three-party game model composed of manufacturers, social media influencers and consumers based on the livestreaming model. It explores the equilibrium strategy selections of each participant in the supply chain system. In analyzing the evolutionary game stability of each participant, this paper obtains the equilibrium strategy and stability factors by analysis of the income and expenditure matrix. It uses the simulation model to analyze reasons for strategy selections of different game participants in the livestreaming e-commerce model. The results show that the strategies of manufacturers, social media influencers and consumers' selections have different impacts on their decision-making mechanism, and man-ufacturers are more sensitive to consumers' active participation in livestreaming e-commerce.

The novel coronavirus (SARS-CoV-2) is a human pathogen recently emerged in China, causing a global pandemic of severe respiratory illness (COVID19). SARS-CoV-2 makes entry into human cells through its spike (S) protein that binds to cell surface receptors. Widespread of SARS-CoV-2 has been attributed to high affinity of S protein to its receptor. A homology model of the receptor binding domain of SARS-CoV-2 S protein (RBD) was built. RBD- receptor docking and published molecular dynamics data were used to map the key RBD-receptor interaction hotspot (RBDhp) on the RBD. Primary virtual screening was carried out against RBDhp using more than 3300 compounds approved by U.S Food and Drug Administration (FDA) and other authorities for human use. Compounds that bind to hpRBD with a binding energy ≤ - 6.5 kcal/mol were subjected to secondary screening using a recently published cryo EM (2.9 Å) structure of RBD. A cardiac glycoside (dgitoxin), two anthracyclines (zorubicin and aclarubicin), a tetracycline derivative (rolitetracycline), a cephalosporin (cefoperazone) and a food dye (E-155) were predicted to be most potent inhibitors of RBD – receptor interaction. An anti-asthmatic drug (zafirlukast) and several other drugs (itrazol, fazadinium, troglitazone, gliquidone, Idarubicin, Oxacillin) were found to be high affinity binders that may have a potential to inhibit RBD – receptor interaction.

This study assesses the development of professional skills in university students using serious games (SG), from a sustainability perspective. The Sustainable Development Goals (SDGs) were set by the United Nations’ 2030 Agenda for Sustainable Development. Universities are strategic agents in the transformation process towards sustainability. This way, they should be committed to promoting such sustainable values in the students through curricular sustainability, implementing active methodologies and SG for that purpose. Transversal skills are essential for the development of future graduates. The objective of this study was to assess which professional skills should be developed through the SG called The Island, to improve the degree of student satisfaction with the incorporation of a sustainable curriculum. The data were obtained using a questionnaire, and then analysed using linear regression models, with their inference estimated through the goodness of fit and ANOVA. The first results indicated that the implementation of the SG promoted a strengthening of the students' sustainable curriculum through the development of those skills. It was concluded that the key to success in education for sustainable development is improving the development of strategic thinking, collaborative thinking, and self-awareness, in addition to encouraging systemic, critical, and problem-solving thinking.

The COVID-19 pandemic drew public attention back to the living conditions related to housing, access to green areas in close neighbourhood and nearby recreation. Several studies confirm that visiting green spaces improved the health and wellbeing in times of crisis. This representative study for the metropolitan area of Vienna, Austria’s capital, confirms the high relevance of contact with nature, particularly for citizens to cope with the negative consequences and perceived stress, anxiety, nervousness and many other negative symptoms experienced during the health crisis. It highlights the importance of nearby smaller but also medium to large scale green areas in cities for health and wellbeing of the population. Moreover, it specifically adds novel insights on age effects in use and perception of urban green spaces during COVID-19 pandemic. The online panel survey (n=1012) was conducted in summer 2021. In order to obtain a representative sample reflective of the population’s characteristics, a (stratified) random sample was selected by applying the quota method. The objective was to obtain a sample which represented gender, age and regional distribution of the population of the City of Vienna as well as the immediately surrounding local communities. Interestingly, particularly young people spent more time outside in green areas during the pandemic, discovered novel spaces for the first time and stated a high relevance of contact with nature for their wellbeing. Elderly people above sixty five, on the contrary, stayed more frequently at home. Significant differences are visible between the age groups also with regard to negative symptoms experienced in case of restricted access to green areas due to strict pandemic measures such as lockdowns and quarantine. All age groups, however, similarly acknowledged the importance of green areas for their physical, mental and emotional health in general during the pandemic.

This research explores the role of transparency and traceability in the agricultural food supply chain. By utilizing blockchain's decentralized and secure features, stakeholders can improve information sharing from farm to consumer, transparency and traceability issues. Real-world examples illustrate blockchain's successful application in agriculture, boosting transparency, efficiency, and trust and create immutable records, enhance visibility, and provide reliable data, while combating fraud and promoting sustainability. It also examines blockchain's impact on food safety through IoT and smart contracts, highlighting successful implementations in supply chain management, the research underscores blockchain's potential to build consumer trust in food safety, quality, and origin.

Africa's health landscape is rapidly changing, requiring new solutions such as a focus on health literacy. However, there is currently a limited overview of the development and application of health literacy in African countries and societies. To inform progress, a scoping review was conducted, including a systematic literature search of research approaches, historical developments, geographic origins, target populations and settings, and topical interests. 336 articles were retrieved from six databases following PRISMA guidelines. Sources identified included reports, policy briefs, book chapters, and research publications. The analysis provided the most comprehensive overview of the current scope and scale of health literacy in Africa to date. The publications represented 38 of the 54 African Union countries and dated back to 2001, although most were published in the last decade. The content analysis identified 13 broad themes, including mental health, communicable diseases, non-communicable diseases, maternal health, digital health, information and communication, health care, prevention and health promotion, conceptual perspectives, cultural perspectives, outcomes and measurement. The stakeholder analysis revealed a wide range of actors involved in different settings, mostly in health care or community settings. These comprehensive and novel findings can be used to prioritize future actions for public and professional capacity building, policy development and improved practice to improve health literacy for all in Africa.

Brazilian garimpeiros are a highly hard-to-reach and mobile population, with little access to basic hygiene and health services, and have been crossing the border to work irregularly in gold mines in French Guiana since the 90s. This study aimed to characterize this population and identify their main health problems. A cross-sectional study was carried out in the municipality of Oiapoque-AP, with two surveys: before (2018) and after (2019) the implementation of Malakit. Individuals were recruited from resting places and submitted to a questionnaire with demographic variables, history and knowledge of malaria, and health issues in the mines. Simultaneously, a clinical evaluation was performed. The garimpeiros were mainly men from Maranhão, Pará, and Amapá, with a low educational level and worked on average for 10 years in the mining sites. The study population mentioned numerous health problems: malaria, followed by leishmaniasis, flu, body aches, headaches, and digestive problems. Other diseases mentioned were skin diseases, bat bites, hepatitis, and HIV infection. This vulnerable population is constantly subjected to heavy routines and exposed to different diseases and infections that can spread across borders. Knowledge of this is essential for developing public health policies that can be integrated into specific epidemiological situations.

Fluoride (iF) is important inorganic pollutant in groundwater in central México. The aim of this study was estimated environmental risk exposure of iF in residents of Jerez Zacatecas México. Fifty-five tap water samples were collected from households to determine iF concentrations using the ion-selective electrode method. Based on these environmental values, the Hazard Quotient (HQ) was estimated following the methodology of the Pan American Health Organization (PAHO). Subsequently, risk maps were generated from these values to visualize the spatial distribution of high-risk areas within the city. iF in tap water ranger in concentration from 1.3 – 7.3 mg/L (ppm). We estimated HQ in a range of 0.63 to 3.73. iF ex-posure in tap water is a health problem that must be addressed, carrying out risk communication actions that allow the population to take care of their health through simple actions, avoiding future health costs.

Substance abuse is a significant public health issue both globally and nationally. Substance abuse involves the detrimental or risky consumption of psychoactive substances, posing a significant global issue, particularly among the youth. In India, cannabis abuse is a major concern. Cannabis is consumed legally in many states as Bhang, also known as marijuana or weed, while Charas and Ganja are illegal under both international drug conventions and the Indian NDPS Act of 1985. The Cannabis users are at great risk of developing Cannabis use disorder which is a pattern of problematic cannabis use leading to clinically significant impairment or distress. It is the most widely used illegal substance worldwide, showing a high prevalence in India.

AbstractBackground: In digitalization era, health care system was conditioned with the health worker’s ability to adapt media of digital technology. Digital technology media was used to strengthening and fasted the health care for patient and community. Aims: This study aimed to explore the accurate information of health professional utilization digital technology during doing the job at the health facilities in Timor-Leste. Methods: This study was used correctional study with 56 respondents was participated in the study. Was collected the data from 1 to 30 February 2023. Was used questioner of google form based for data collection. Data collection was distributed via online with google form to social media as WhatsApp’s, email and face book and twitter to completed by respondents. The inclusive Criteria are: health professional living in Timor-Leste, to able response the questioner. Was used descriptive analysis in this study. Finding: This study was indicated that majority of health professional was participated in the study as 54,2% man then women have 45,8%. About 100% health professional used hand phone to facilitate their daily activities including related with their work activities. Other side indicated in digital technology tools use are able to use Microsoft word is 78,3%, able to use Microsoft Excel is 76,7% and able to use Power Point is 81,7%. E-mail use about 89,2%, WhatsApp’s use 81,7%, About 74,2% was used zoom/webinars/Google meet application, about 72,5% sad that they were used computer in the work place until now. Around 96.4% need to improve or deepen their knowledge and skills in using ICT in the future to facilitate they are activity. Conclusion: Majority of health professional in Timor-Leste was used the computer, internet, hand phone in daily activities. Majority need to gate the training to improve their knowledge, attitude and psychomotor in the future.

This review paper investigates the intricate relationship between sexuality and body dysmorphia, emphasizing its profound impact on mental health. Through a critical examination of existing literature, this study illuminates the complex psychological, societal, and cultural dynamics at play within this intersection. Special attention is given to the influence of media representations and societal beauty standards in shaping individual perceptions and experiences. Furthermore, the paper discusses various therapeutic interventions designed to address this interplay, underscoring the necessity for mental health practices that are both sensitive and adaptable to the nuances of these issues. Ultimately, this work enriches the discourse on body image and sexual health, offering critical insights for clinical interventions and highlighting areas for further research.

This article examines the intersection of race and disability in the context of health disparities. It highlights the unique challenges faced by individuals with disabilities who also belong to racialized minority groups, who experience a double burden of discrimination and marginalization. The article draws upon various conceptual models of disability, including the medical, social, and biopsychosocial models, to illustrate the multifaceted nature of disability and its impact on health outcomes. It then examine the specific health disparities faced by individuals with disabilities, including higher rates of chronic diseases, limited access to healthcare, and lower life expectancy. The concept of intersectionality is introduced to explain how race and disability interact and amplify each other, creating greater disadvantages for individuals at this intersection. This is further explored through discussions on social determinants of health (SDOH), such as poverty, food insecurity, and inadequate housing, which disproportionately affect racialized minorities with disabilities. The article concludes by suggesting directions for future research and policy interventions. It emphasizes the need for culturally sensitive research, long-term analyses, qualitative studies, and a focus on policy implications. Additionally, it calls for regional considerations, a more holistic understanding of health determinants, and an expansion of the intersectional approach beyond race and disability.